Gastrointestinal Disorders after Renal Transplantation

Abstract

Gastrointestinal complications after renal transplantation continue to be of considerable concern. Among the commonly used immunosuppressive drugs, corticosteroids, mycophenolate mofetil, and azathioprine are mostly responsible for gastrointestinal side effects. The direct gastrointestinal toxicity of immunosuppressive drugs only rarely necessitates the discontinuation of the respective agent. Exceptionally dangerous gastrointestinal disorders are intestinal perforation and acute pancreatitis. The most prominent gastrointestinal infections are esophageal candidiasis and cytomegalovirus infection. In contrast to the other gastrointestinal malignancies, a particularly elevated occurrence of Kaposi’s sarcoma can be demonstrated for kidney transplant recipients, compared to the general population. The diagnosis and treatment of gastrointestinal complications are often difficult because immunosuppressive agents attenuate the clinical symptoms. Preoperative screening for gastrointestinal ulcera and colonic diverticula in high risk patients and prophylactic antiulcer and antifungal treatment are important for prevention of gastrointestinal complications.