Colorectal Surgery after Kidney Transplant: Characteristics of Early vs. Late Post-Transplant Interventions
Department of Surgery, Division of Colon and Rectal Surgery, University of Minnesota, Minneapolis, MN
Department of Surgery, Hennepin County Medical Center, Minneapolis, MN
Department of Surgery, Division of Transplantation, University of Minnesota, Minneapolis, MN
Meeting: 2013 American Transplant Congress
Abstract number: D1741
Aim: We hypothesized that kidney transplant recipients undergoing colorectal surgery <1 year of transplant would have more complications than those >1 year post-transplant.
Methods: We reviewed kidney transplant recipients who had colorectal surgery from 6/1/00 to 6/1/12, measuring major complications at 30 days, postop length of stay (LOS), mortality, reoperations, and readmissions at 60 days.
Results: We identified 45 patients in the study period:<1 year (9/45, 20%) and >1 year (36/45, 80%). Gastrointestinal cancer (31%), diverticulitis (24%), and ischemic colitis (16%) were the most common indications for surgery. Ischemic colitis was higher in the <1 year group (44% vs 6%, p=0.01). The <1 year group had a higher incidence of emergency cases(100% vs. 33%, p=0.0003). The <1 year group also had a higher incidence of blood transfusion (78% vs 31%, p=0.02), longer LOS (23.2±12 vs 11.7±10d, p = 0.02), and higher periop mortality rate (33% vs 6%, p=0.047). These differences were not significant when comparing only emergent cases. We found no significant differences in major complications, reoperations, or readmissions.
| Variable, n(%) | <1 year (n=9) | > 1 year (n=36) | p-value |
| Male | 5(56) | 20(56) | 1 |
| Age, mean y(sd) | 49.4(13) | 56.25(11) | 0.16 |
| Charlson Score, mean(sd) | 5.2(2) | 5.6(3) | 0.60 |
| Preop prednisone use | 7(78) | 25(69) | 1.00 |
| Colon cancer | 0 | 11(31) | 0.09 |
| Diverticulitis | 1(11.1) | 11(31) | 0.41 |
| Ischemic colitis | 4(44.4) | 2(6) | 0.01 |
| Emergency cases | 9(100) | 12(33) | 0.0003 |
| EBL, mean ml(sd) | 325.6(447) | 238.7(213) | 0.59 |
| Operative length, mean min(sd) | 207.9(40) | 201(83) | 0.72 |
| Stoma formation, n(%) | 7(78) | 14(39) | 0.06 |
| Received blood transfusion | 7(78) | 11(31) | 0.02 |
| LOS, mean d(sd) | 23.2(12) | 11.7(10) | 0.02 |
| Reoperations | 2(22) | 4(11) | 0.58 |
| Readmissions within 60 days | 3(33) | 10(3) | 0.70 |
| Major complications (1 or more) | 6(67) | 12(33) | 0.13 |
| Death | 3(33) | 2(6) | 0.047 |
Conclusion: Kidney transplant recipients undergoing colorectal surgery <1 year post-transplant have a higher incidence of emergency surgery and ischemic colitis than patients >1 year post-transplant. Despite these findings, patients with grafts <1 year had a similar postoperative complication rate to patients with grafts >1 year.
To cite this abstract in AMA style:
Lee J, Kwaan M, Sirany A, Melton G, Madoff R, Dunn T. Colorectal Surgery after Kidney Transplant: Characteristics of Early vs. Late Post-Transplant Interventions [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/colorectal-surgery-after-kidney-transplant-characteristics-of-early-vs-late-post-transplant-interventions/. Accessed November 22, 2024.« Back to 2013 American Transplant Congress