Acute Appendicitis in the Early Stage after Orthotopic Liver Transplantation

Huang, Junfeng; Ma, Jie-fei; Gong, Yu; Liu, Yü; Cui, Cheng‐Bin; Long, Yang; Zhou, Jian; Zhu, Dexiang; Wang, Ting

doi:10.4103/0366-6999.205861

Cited by 3 publications

(13 citation statements)

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“…[5,8,9,11] The first publication regarding AAp in patients with LT was published in 2005 by Abt et al, [11] and since then, 14 articles have been published with one being a review article. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Our literature review with 33 LT patients who received appendectomy for AAp has been summarized in Table 3. The studies in the field show that AAp incidence in patients with LT ranges between 0.09%-0.67%.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] Epidemiologic studies state that the risk of undergoing an appendectomy at any point in their lives in male and female patients is 12% and 23%, gested that transplant patients may have a higher rate of late diagnosis and risk of fatal complications, such as perforation and abscess formation, due to immunosuppressive therapy received in the postoperative period. [7] The present study aims to compare the demographic and clinicopathologic data of the immunosuppressed liver transplant (LT) recipients who underwent an appendectomy due to AAp to that of their non-transplant counterparts who underwent appendectomy during the same period. This study will provide an indirect means of investigation of the effects of immunosuppressive therapy on the signs and symptoms of inflammation in AAp.…”

Section: Introductionmentioning

confidence: 99%

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Liver transplant versus non-liver transplant patients underwent appendectomy with presumed diagnosis of acute appendicitis: Case Control Study

Sarıcı

Akbulut

Koç

et al. 2020

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: This study aims to compare liver transplant and non-liver transplant patients who underwent appendectomy with a presumed diagnosis of acute appendicitis. METHODS:Demographic and clinicopathological features of 13 liver transplant recipients (transplant group) who underwent posttransplant appendectomy with a presumed diagnosis of acute appendicitis were compared with the features of 52 non-liver transplant patients (non-transplant group). They underwent appendectomy with a presumed diagnosis of acute appendicitis during the same time period. The transplant group was matched at random in a 1: 4 ratio with the non-transplant group. While the continuous variables were compared using the Mann Whitney-U test, categorical variables were compared with Fisher's exact test. A p-value of less than 0.05 was considered statistically significant. RESULTS:A total of 65 patients aged between one year and 84 years were included in this study. While the age of the 52 patients (32 male and 20 female) in the non-transplant group ranged from 17 years to 84 years, the age of the 13 patients (nine male and four female) in the transplant group ranged from one year to 64 years. Statistically significant differences were noted between both groups concerning WBC (p=0.002), neutrophil (p=0.002), lymphocyte (p=0.032), platelets (p=0.032), RDW (p=0.001), CRP (p=0.009), PNR (p=0.042), WNR (p=0.03), and appendiceal length (p<0.001). The negative appendectomy rate was relatively higher in transplant than the non-transplant group but this difference was not statistically significant (30.8% vs. 21.2%; p=0.477). Perforated acute appendicitis occurred more frequently in the transplant group; however, this difference was not statistically significant (30.8% vs. 9.6%; p=0.070). CONCLUSION:WBC and neutrophil were lower in the LT group; however, the CRP and RDW were higher in the LT group. Further, perforation and negative appendectomy rates were higher in the LT group, although this difference was not statistically significant.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Liver transplant versus non-liver transplant patients underwent appendectomy with presumed diagnosis of acute appendicitis: Case Control Study

Sarıcı

Akbulut

Koç

et al. 2020

Ulus Travma Acil Cerrahi Derg

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“…Treatment of acute appendicitis is achieved with an open surgical or laparoscopic appendectomy. We preferred to perform an open appendectomy, though in recent years, cases managed with a laparoscopic appendectomy have been reported with promising outcomes [ 1 – 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence rate of acute appendicitis following liver transplantation (LT) has been reported as 0.09% to 0.49%, and thus far, the largest case series cited in the English-language medical literature are 6 reports, which include a total of 32 cases worldwide [ 1 – 10 ]. The present study found an incidence of appendicitis developing after LT of 0.35% (7/1990), and is the third largest case series in the literature.…”

mentioning

confidence: 99%

“…Thus far, there has been no evaluation in the medical literature of the use of the Alvarado scoring system in the diagnosis of acute appendicitis following LT. Though the traditional treatment is open appendectomy, in recent years, case presentations of laparoscopic appendectomy have been reported [ 1 – 3 ]. In this study, the diagnostic efficacy of the Alvarado score in 7 patients who developed acute appendicitis after LT and the clinical management of acute appendicitis in this special patient group were investigated.…”

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confidence: 99%

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The management of acute appendicitis in liver transplant patients: How effective is the Alvarado score?

Ince

Barut

Özdemir

et al. 2017

North Clin Istanbul

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OBJECTIVE:The incidence of acute appendicitis after liver transplantation (LT) is extremely low, reported to be 0.09% to 0.49%, but the efficacy of the Alvarado score in this patient group has not been studied. This study was an investigation of the clinical management of patients who developed acute appendicitis after LT and the usefulness of the Alvarado score in the diagnosis.METHODS:The study was performed using the data of 7 patients treated for acute appendicitis who were among 1990 patients who underwent LT between March 2002 and July 2017. The Alvarado score of the patients was calculated and reliability was analyzed.RESULTS:In this study, the incidence of acute appendicitis in LT patients was 0.35%. All of the patients were in the adult age group; 86% were male. The mean age was 46.4±10.7 years and the timeframe for the development of appendicitis after transplantation was a median of 12 months (range: 4-101 months). The median Alvarado score was 7 (range: 5-9). All of the patients had an Alvarado score above 5 and 71% had a score of 7 or more.CONCLUSION:Acute appendicitis is very rare in LT patients. As with non-transplant patients, Alvarado scoring can be safely performed in LT patients.

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Acute appendicitis after liver transplantation: A single center experience and review of the literature

Jamtani

Kim

Lee

et al. 2020

Ann Hepatobiliary Pancreat Surg

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Backgrounds/Aims: Acute appendicitis is one of the most common emergent disease in the general population requiring surgical treatment. However, only a few cases of appendicitis after liver transplantation (LT) were reported. We described experiences of acute appendicitis after LT in single center. Methods: From March 1988 to July 2019, we reviewed retrospectively all the patients who diagnosed with acute appendicitis after LT at the Seoul National University Hospital. We described and analyzed clinical outcomes of appendectomy after LT. Results: A total of 12 patients out of 2,237 LT patients underwent appendectomy due to acute appendicitis. The mean age was 48±12 years. Nine patients (75%) underwent deceased donor liver transplantation (DDLT) and three patients (25%) underwent living donor liver transplantation (LDLT). The mean days from transplantation to the onset of acute appendicitis was 739 (range 57-4,496) days. Every patients underwent appropriate appendectomy within 1 days after visiting hospital. Leukocytosis was seen in three patients (25%). Seven patients (58%) underwent laparoscopic appendectomy and five patients (42%) underwent open appendectomy. The total operative time was 47.5 (range 25-135) minutes. The median postoperative hospitalization was 4 (range 2-11) days. There was no postoperative complications documented. There was no significant difference of clinical outcomes between laparoscopic appendectomy group and open appendectomy group. Conclusions: Early surgical management achieved satisfactory postoperative results without graft dysfunction after LT. Laparoscopic appendectomy also could be applicable with safe and feasible outcomes even in post-LT recipients.

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Acute Appendicitis in the Early Stage after Orthotopic Liver Transplantation

Cited by 3 publications

References 4 publications

Liver transplant versus non-liver transplant patients underwent appendectomy with presumed diagnosis of acute appendicitis: Case Control Study

Liver transplant versus non-liver transplant patients underwent appendectomy with presumed diagnosis of acute appendicitis: Case Control Study

The management of acute appendicitis in liver transplant patients: How effective is the Alvarado score?

Acute appendicitis after liver transplantation: A single center experience and review of the literature

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