Gastrointestinal complications in renal transplant recipients detected by endoscopic biopsies in a developing country

Ishaque, Muhammed; Rashid, Rahma; Mubarak, Muhammed

doi:10.1007/s12664-015-0537-8

Cited by 10 publications

(10 citation statements)

References 29 publications

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“…Thirty two percent of our patients were found to have H. pylori infection in comparison to Ozgur et al and Hurby's, who reported it this infection in 70 and 62% respectively [ 8 , 17 ]. Another study done at the same institute as ours (SIUT) reported H. pylori infection in 11 patients out of 119 examined gastric biopsies, showing decrease prevalence of this infection in our renal transplanted population [ 18 ]. A possible explanation of the differences of these results is yet to be known.…”

Section: Discussionmentioning

confidence: 90%

Factors leading to dyspepsia in renal transplant recipients

Nazeer¹,

Aslam²,

Luck³

2017

Pan Afr Med J

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IntroductionRenal transplantation is the definitive treatment for end stage renal disease. Patients subjected to transplantation require lifelong immunosuppression and are prone to several gastrointestinal disorders. Dyspepsia is a common disorder in these patients. The objective of this study was to determine factors leading to dyspepsia in renal (kidney) transplant recipients.MethodsIt was a cross sectional study conducted at department of hepatogastroenterology and transplant sciences, SIUT Karachi, from 1-6-15 to 1-12-15 for six months. All renal transplanted patients having dyspeptic symptoms for more than 6 weeks. EGD was performed, biopsy specimens obtained from antrum and duodenum, these were sent for histopathological examination. Frequency and percentages were obtained for categorical variables, mean ± SD was calculated for continuous variables. Chi square test was used for categorical variable and student t-test for continuous variables.ResultsNinety patients were included in the study out of which 64 (71.1%) were males, mean age was 35.82 ± 10.04 years (range: 18-65 years). Gastritis (non H.pylori associated) in 78 (78.6%), duodenitis in 35 (38.9%) and H. pylori infection in 29 (32.2%), renal transplant recipients. Most of the patients belonged to Sindhi ethnicity, 27 (30%), followed by Punjabi. Hypertension was the most common co-morbid condition in our patients found in 29 (32.2%), while most of them don't have any co morbid condition. Duodenitis was found to be associated with tacrolimus use (p = 0.037).ConclusionGastritis is the most common factor accountable for this symptoms, followed by duodenitis and H. Pylori. Patients taking tacrolimus as immunosuppressant are more prone to develop duodenitis.

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Section: Discussionmentioning

confidence: 90%

Factors leading to dyspepsia in renal transplant recipients

Nazeer¹,

Aslam²,

Luck³

2017

Pan Afr Med J

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“…Duodenitis was associated with tacrolimus use [51]. Interestingly, a lower HP gastritis rate of 9.2 to 29% has been reported in gastric biopsies of kidney transplant patients [16,48,52]. However, in a small cohort, kidney transplant recipients have had a higher prevalence of HP infection than dialysis and control dyspeptic patients (62% vs. 34.6 and 43.6%, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…Candidate patients on the kidney transplant waiting list are carefully evaluated for absolute and relative contraindications before transplantation. The transplant recipients are susceptible to a variety of gastrointestinal complications such as infections, ulcer disease and malignancies [16]. In addition, immunosuppressive drugs, especially corticosteroids, used after kidney transplantation have adverse effects on the gastrointestinal tract (peptic ulcer bleeding, perforation, gastritis and esophagitis).…”

Section: Introductionmentioning

confidence: 99%

Comparison of endoscopic and pathological findings of the upper gastrointestinal tract in transplant candidate patients undergoing hemodialysis or peritoneal dialysis treatment: a review of literature

et al. 2020

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Background Dyspepsia is a common disorder in kidney transplant recipients, and the risk of post-transplant complications is increased in candidates with upper gastrointestinal disease. We evaluated gastrointestinal lesions of kidney transplant candidates on dialysis. Methods In this study, endoscopic and pathological findings in hemodialysis (HD) and peritoneal dialysis (PD) patients with gastrointestinal symptoms on the waiting list were compared. Results The most common non-ulcerous lesions in the endoscopic examination were gastritis (62.3%), erosive gastritis (38.7%), duodenal erosion or duodenitis (18.9%) and esophagitis (13.2%). The ulcerous lesion was present in only 3 patients. Gastroesophageal reflux disease, ulcerated lesion and non-ulcerated lesion rates were similar in both dialysis groups. Histopathological examination revealed Helicobacter pylori (HP) positivity in 28.3% of patients. HP positivity rate was significantly higher in PD patients than in HD patients (38.7% vs. 13.6%, p = 0.046). Chronic gastritis (75.5%) was the most common pathological finding. HP positivity rate was 37.5% in patients with chronic gastritis, but HP was negative in patients without chronic gastritis. In multivariate analysis, male gender, urea and albumin levels were associated with the presence of pathological chronic gastritis. The presence of gastritis, total cholesterol and ferritin levels were found significant for HP positivity. A total cholesterol > 243 mg/dL was significantly related to an increased risk of the presence of HP positivity. Conclusions Gastrointestinal lesions and HP infection are common in dialysis patients. Dialysis modality may affect the frequency of some lesions. It may be useful to have an endoscopic examination before entering the transplant waiting list for all candidates.

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“…These symptoms may be due to the numerous immunosuppressive medications many patients take on a daily basis, such as mycophenolate mofetil (MMF). Significantly, nausea, vomiting, dyspepsia, and anorexia have been found to be frequent in patients who are on MMF [6]. Based on our findings, 95% of patients were discharged home with MMF as part of their immunosuppression regimen, which may play a significant role in the development of their upper GI symptoms leading to frequent readmissions post-transplant.…”

Section: Discussionmentioning

confidence: 57%

Nausea, Vomiting, and Dyspepsia Following Solid Organ Abdominal Transplant

Jarrett¹,

Lo²,

Body³

et al. 2022

Cureus

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Background and objectiveMultiple comorbidities may contribute to high readmission rates post-transplant procedures. In this study, we aimed to assess the rates and factors associated with hospital readmissions for dyspeptic symptoms among transplant patients. MethodsThis was a retrospective analysis of adult patients who underwent solid organ transplants at our institution. Pregnant patients or those patients with preexisting gastroparesis were excluded from the study. Readmissions associated with the International Classification of Diseases (ICD) codes for nausea/vomiting, weight loss, failure to thrive, abdominal pain, and/or bloating were included. Factors associated with 30-day and frequent readmissions (two or more) were explored. ResultsA total of 931 patients with solid organ transplants were included; 54% had undergone kidney transplants while 34% were liver transplants. Of note, 30% were readmitted within the first 30 days after discharge following transplant while 32.3% had frequent readmissions. A post-transplant upper endoscopy (EGD) was performed in 34% with food residue discovered in 19% suggesting gastroparesis. However, since only 22% of these patients had a gastric emptying study, only 6% were formally diagnosed with gastroparesis, which was independently associated with both 30-day [odds ratios (OR): 2.58, 95% confidence intervals (CI): 1.42-4.69] and frequent readmissions (OR: 6.71, 95% CI: 3.45-13.10). The presence of pre-transplant diabetes (35%) was significantly associated with a diagnosis of gastroparesis following transplant (OR: 5.17, 95% CI: 2.79-9.57). The use of belatacept (OR: 0.63, 95% CI: 0.42-0.94, p=0.023) was associated with a decrease in the odds of 30-day readmissions. ConclusionA significant number of patients were readmitted due to dyspeptic symptoms after solid organ transplants. Diabetes and gastroparesis were significantly associated with higher odds of readmissions while the use of belatacept appeared to be a protective factor.

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Gastrointestinal complications in renal transplant recipients detected by endoscopic biopsies in a developing country

Abstract: A wide spectrum of pathological lesions including opportunistic infections was seen in GI endoscopic biopsies in renal transplant patients. Endoscopic biopsies play an important role in the diagnosis and management of GI disease in renal transplant patients.

Cited by 10 publications

References 29 publications

Factors leading to dyspepsia in renal transplant recipients

Factors leading to dyspepsia in renal transplant recipients

Comparison of endoscopic and pathological findings of the upper gastrointestinal tract in transplant candidate patients undergoing hemodialysis or peritoneal dialysis treatment: a review of literature

Nausea, Vomiting, and Dyspepsia Following Solid Organ Abdominal Transplant

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