Expectant Management Is Safe for Cholelithiasis After Heart Transplant

Sinanan, Mika; Fishbein, Daniel P.; Aldea, Gabriel S.; Verrier, Edward D.; Salerno, Christopher T.

doi:10.1016/j.healun.2005.12.010

Cited by 18 publications

(13 citation statements)

References 7 publications

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“…They were carried out in ten different countries, particularly in Europe ( n = 11) [13, 14, 18, 24, 28–30, 34, 35, 38, 40], North America ( n = 24) [2, 4, 11, 12, 15–17, 19, 21–23, 25–27, 31, 33, 36, 37, 39, 41, 43–46], Asia and Pacific ( n = 4) [20, 32, 42, 47]. The overall number of transplanted patients considered was 71671.…”

Section: Resultsmentioning

confidence: 99%

Emergency abdominal surgery after solid organ transplantation: a systematic review

et al. 2016

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AimsDue to the increasing number of solid organs transplantations, emergency abdominal surgery in transplanted patients is becoming a relevant challenge for the general surgeon. The aim of this systematic review of the literature is to analyze morbidity and mortality of emergency abdominal surgery performed in transplanted patients for graft-unrelated surgical problems.MethodsThe literature search was performed on online databases with the time limit 1990–2015. Studies describing all types of emergency abdominal surgery in solid organ transplanted patients were retrieved for evaluation.ResultsThirty-nine case series published between 1996 and 2015 met the inclusion criteria and were selected for the systematic review. Overall, they included 71671 transplanted patients, of which 1761 (2.5 %) underwent emergency abdominal surgery. The transplanted organs were the heart in 65.8 % of patients, the lung in 22.1 %, the kidney in 9.5 %, and the liver in 2.6 %. The mean patients’ age at the time of the emergency abdominal surgery was 49.4 ± 7.4 years, and the median time from transplantation to emergency surgery was 2.4 years (range 0.1–20). Indications for emergency abdominal surgery were: gallbladder diseases (80.3 %), gastrointestinal perforations (9.2 %), complicated diverticulitis (6.2 %), small bowel obstructions (2 %), and appendicitis (2 %). The overall mortality was 5.5 % (range 0–17.5 %). The morbidity rate varied from 13.6 % for gallbladder diseases to 32.7 % for complicated diverticulitis. Most of the time, the immunosuppressive therapy was maintained unmodified postoperatively.ConclusionsEmergency abdominal surgery in transplanted patients is not a rare event. Although associated with relevant mortality and morbidity, a prompt and appropriate surgery can lead to satisfactory results if performed taking into account the patient’s immunosuppression therapy and hemodynamic stability.

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Section: Resultsmentioning

confidence: 99%

Emergency abdominal surgery after solid organ transplantation: a systematic review

et al. 2016

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“…Kao et al [28] reported a comparative mortality of 5:1,000 deaths for prophylactic postcardiac transplant cholecystectomy compared to a figure of 80:1,000 deaths and 44:1,000 deaths for pretransplant cholecystectomy and expectant management, respectively. By and large, most recent studies report favourable results of expectant management in patients undergoing cardiac and bone marrow transplantation [29] and suggest that cholecystectomy after onset of symptoms is safe.…”

Section: Transplant Recipientsmentioning

confidence: 99%

Asymptomatic Gallstones (AsGS) – To Treat or Not to?

Behari

Kapoor

2011

Indian J Surg

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“…Cholecystitis and choledocholithiasis with or without cholangitis, gallstone pancreatitis, and gallstone ileus are more prevalent (10-55%) in adult heart transplant recipients than the general population (8). Cholecystitis and choledocholithiasis with or without cholangitis, gallstone pancreatitis, and gallstone ileus are more prevalent (10-55%) in adult heart transplant recipients than the general population (8).…”

Section: Discussionmentioning

confidence: 99%

“…Abdominal pain and fever are common findings in patients after solid organ transplantation and significant gastrointestinal complications may occur in patients after cardiac transplantation. Cholecystitis and choledocholithiasis with or without cholangitis, gallstone pancreatitis, and gallstone ileus are more prevalent (10-55%) in adult heart transplant recipients than the general population (8). In children, the prevalence of biliary disease was 6%; however, 80% of patients had evidence of bile sludge without calculi (9).…”

Section: Discussionmentioning

confidence: 99%