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

被引:10
作者
Ishaque M. [1 ]
Rashid R. [1 ]
Mubarak M. [1 ]
机构
[1] Javed I. Kazi Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi
关键词
Endoscopic biopsies; Immunosuppression; Opportunistic infections; Pathological lesions; Renal transplant recipients;
D O I
10.1007/s12664-015-0537-8
中图分类号
学科分类号
摘要
Background: Renal transplantation is the treatment of choice for patients with end-stage renal disease. The renal transplant recipients are susceptible to a variety of gastrointestinal (GI) complications such as infections, ulcer disease, and malignancies. Objectives: We aimed to determine the frequency of pathological lesions in GI endoscopic biopsies in recipients of live related renal transplantation in our setting. Methods: This retrospective survey was carried out at Histopathology Department of Sindh Institute of Urology and Transplantation, Karachi, from December 2010 to January 2011. All consecutive renal transplant patients of all ages and both genders on regular follow up, presenting with GI complaints and in whom GI endoscopic biopsies were performed, were included. The demographic, clinical, and laboratory data were retrieved from case files and the pathological diagnoses from the original biopsy reports. Results: A total of 200 consecutive renal transplant patients were enrolled. The biopsies comprised of 19 (9.5 %) esophageal biopsies, 119 (59.5 %) gastric biopsies, 148 (74 %) duodenal biopsies, and 66 (33 %) colorectal biopsies. The main pathological lesions included cytomegalovirus infection in 22 (11 %) of all patients, Helicobacter pylori in 11 (9.2 %) of gastric biopsies, cryptosporidium in 4 (1.6 %), giardiasis in 30 (15 %), immunoproliferative small intestinal disease in 5 (3.4 %), tropical sprue in 33 (15 %), tuberculosis in 3 (2 %) of the small intestinal biopsies, and gastric adenocarcinoma in 1 (1.7 %) gastric biopsy. Conclusion: 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. © 2015, Indian Society of Gastroenterology.
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页码:51 / 57
页数:6
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共 33 条
[1]  
Abbas K., Muzzafar R., Zafar M., Mubarak M., Naqvi S., Rizvi S., Evaluation of pre-transplant T-cell activation status by soluble CD30 determination, J Pak Med Assoc, 59, pp. 212-215, (2009)
[2]  
Ponticelli C., Passerini P., Gastrointestinal complications in renal transplant recipients, Transpl Int, 18, pp. 643-650, (2005)
[3]  
Abbas Z., Hassan S., Naqvi S., Rizvi S., Weight loss in renal transplant recipients, J Nephrol Urol Transplant, 3, pp. 11-13, (2002)
[4]  
Sarkio S., Halme L., Kyllonen L., Salmela K., Severe gastrointestinal complications after 1,515 adult kidney transplantation, Transpl Int, 17, pp. 505-510, (2004)
[5]  
Pahl M., Vaziri N., Martin D., Pathology of digestive organs in renal transplant recipients, J. Natl Med. Assoc, 78, pp. 721-726, (1986)
[6]  
Archibald S., Jirsch D., Bear R., Gastrointestinal complications of renal transplantation, Can Med Assoc J, 119, pp. 1291-1296, (1978)
[7]  
Stelzner M., Vlahakos D., Milford E., Tilney N., Colonic perforations after renal transplantation, J Am Coll Surg, 184, pp. 63-69, (1997)
[8]  
Helderman J., Goral S., Gastrointestinal complications of transplant immunosuppression, J Am Nephrol, 13, pp. 277-287, (2002)
[9]  
Tappeh K., Gharavi M., Makhdoumi K., Rahbar M., Taghizadeh A., Prevalence of Cryptosporidium ssp. infection in renal transplant and hemodialysis patients, Iran J Publ Health, 3, pp. 54-57, (2006)
[10]  
Rostami M., Keshavarz H., Eskandari E., Kia E., Rezaeian M., Intestinal parasites in renal transplant recipients, Iran J Parasitol, 3, pp. 16-23, (2007)