Treatment and outcome of intestinal perforation after liver transplant surgery in adults: a single-center experience

Abstract

ObjectiveIntestinal perforation is a rare complication after liver transplantation. This study was designed to calculate the incidence and investigate the outcomes of intestinal perforation in adult liver transplant patients.Materials and methodsThe clinical records of liver transplant recipients between January 2014 and June 2016 were obtained. The incidence of intestinal perforation was calculated, and high risk factors were analyzed.ResultsThe mean operative time was 8.5 h (range: 6–11 h). The mean portal vein occlusion time was 66.5 min (range: 58–72 min), and the mean cold ischemia time was 7.9 h (range: 6.5–9.5 h). Four (2.7%) patients developed intestinal perforation from 9 to 14 days postliver transplant. All perforations were single and repaired by interrupted silk sutures. Two patients uneventfully recovered, but intestinal perforation recurred in two other patients. Simple repair was undertaken in one patient, and terminal ileum resection and ileostomy were performed in the other patient. There were no perioperative deaths.ConclusionThe incidence of intestinal perforation after liver transplantation is low. Prompt diagnosis and treatment should be carried out to reduce comorbidities and mortality.

Determination of risk factors affecting mortality in patients with gastrointestinal perforation after pediatric liver transplantation

“…Typical clinical manifestations, such as abdominal pain and tenderness, nausea and vomiting, fever, and leukocytosis, may be obscured due to high‐dose immunosuppressive agents, which might delay early diagnosis . In the present study, we diagnosed GIP based on clinical examinations and laboratory tests.…”

Gastrointestinal Perforation After Solid Organ Transplantation: A Case Series

“…Most deaths occur due to late diagnosis, mucosal inflammation, and septicemia. Lin et al [11] described four patients (2.7%) who experienced colonic perforation 9-14 days post-liver transplantation. In these patients, the perforation hole was sutured, the affected bowel segment was resected, and colonic continuity was established.…”

Gastrointestinal perforation in liver transplantation recipients: risk factors analysis from a 10-year retrospective study with an international multicenter survey about management strategies

“…reported a series of 187 adult LT with an incidence of 6 GI perforations and a mortality of 50%, without analysis of risk factors or different management options according to the site of perforation [14]. Similarly, other 2 papers from Middle and Eastern Asia experiences show a superimposable incidence and mortality rate, within a population of less than 300 LT [16,17].…”