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Thomas M. Beaver
David A. Fullerton
David N. Campbell
Frederick L. Grover
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Ann Thorac Surg 1996;62:839-843
© 1996 The Society of Thoracic Surgeons

Original Articles: General Thoracic

Colon Perforation After Lung Transplantation

Thomas M. Beaver, MD, David A. Fullerton, MD, Martin R. Zamora, MD, David B. Badesch, MD, David Weill, MD, James M. Brown, MD, David N. Campbell, MD, Frederick L. Grover, MD

Divisions of General and Cardiothoracic Surgery and Pulmonary and Critical Care Medicine, University of Colorado Health Sciences Center, Denver, Colorado

Accepted for publication April 23, 1996.

Background. Colon perforation has been previously described after solid organ transplantation. Since the inception of the lung transplant program at the University of Colorado 60 isolated lung transplantations have been performed. Four of these patients have suffered spontaneous colonic perforation.

Methods. The case history of each lung transplant patient with a colon perforation and the literature were reviewed.

Results. An increased incidence of colon perforation in lung transplant patients was identified. Diverticulitis was found to be the predominant cause, and an association with steroids was noted. The two deaths in this series were in patients receiving high-dose steroids in whom invasive Aspergillus infections developed.

Conclusions.Careful screening of the gastrointestinal tract before transplantation is advocated. A steroid-sparing immunosuppressive regimen is recommended. All lung transplant patients with abdominal complaints require an aggressive work-up, and surgeons should have a low threshold for laparotomy. Conservative surgical principles, including resection of the perforated segment of colon and proximal end-colostomy rather than primary anastomosis, are necessary for the optimal outcome.




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[Abstract] [Full Text] [PDF]


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