BACKGROUND: Preexisting gallstones and pharmacologic alterations in both bile lithogenicity and immune function may predispose organ transplant recipients to the complications of biliary calculi. METHODS: Records of all 178 patients undergoing heart, lung, or heart-lung transplantation at our institution between 1980 and 1998 were reviewed. Patients with biliary tract disease were grouped as follows: group I, pretransplantation diagnosis and treatment; group II, pretransplantation diagnosis and posttransplantation treatment; group III, normal pretransplantation biliary tree with posttransplantation diagnosis and treatment; group IV, unknown pretransplantation biliary status with posttransplantation diagnosis and treatment. Comparison among groups was made with regard to ultrasound findings, presentation, indication for operation, procedure, and outcome. RESULTS: Of the 141 patients undergoing pretransplantation and/or posttransplantation ultrasound surveillance, the prevalence of abnormal ultrasonography was 36%. All patients in group I (n = 11) underwent elective intervention without complication. Of the 14 patients (groups II through IV) undergoing posttransplantation operation, intervention was mandated by acute complications of biliary tract disease in 7. The mortality rate in these 7 patients was 29%. CONCLUSIONS: Cholecystectomy in the posttransplantation period is often required emergently and has a high mortality. Posttransplantation surveillance of the biliary tree is crucial because of the high rate of de novo stone formation. All biliary calculi should be eradicated electively in stable patients before transplantation and on diagnosis after transplantation.
BACKGROUND: Preexisting gallstones and pharmacologic alterations in both bile lithogenicity and immune function may predispose organ transplant recipients to the complications of biliary calculi. METHODS: Records of all 178 patients undergoing heart, lung, or heart-lung transplantation at our institution between 1980 and 1998 were reviewed. Patients with biliary tract disease were grouped as follows: group I, pretransplantation diagnosis and treatment; group II, pretransplantation diagnosis and posttransplantation treatment; group III, normal pretransplantation biliary tree with posttransplantation diagnosis and treatment; group IV, unknown pretransplantation biliary status with posttransplantation diagnosis and treatment. Comparison among groups was made with regard to ultrasound findings, presentation, indication for operation, procedure, and outcome. RESULTS: Of the 141 patients undergoing pretransplantation and/or posttransplantation ultrasound surveillance, the prevalence of abnormal ultrasonography was 36%. All patients in group I (n = 11) underwent elective intervention without complication. Of the 14 patients (groups II through IV) undergoing posttransplantation operation, intervention was mandated by acute complications of biliary tract disease in 7. The mortality rate in these 7 patients was 29%. CONCLUSIONS: Cholecystectomy in the posttransplantation period is often required emergently and has a high mortality. Posttransplantation surveillance of the biliary tree is crucial because of the high rate of de novo stone formation. All biliary calculi should be eradicated electively in stable patients before transplantation and on diagnosis after transplantation.
Authors: William S Richardson; Walter J Surowiec; Kristine M Carter; Todd P Howell; Mandeep R Mehra; John C Bowen Journal: Ann Surg Date: 2003-02 Impact factor: 12.969
Authors: Federico Coccolini; Mario Improta; Massimo Sartelli; Kemal Rasa; Robert Sawyer; Raul Coimbra; Massimo Chiarugi; Andrey Litvin; Timothy Hardcastle; Francesco Forfori; Jean-Louis Vincent; Andreas Hecker; Richard Ten Broek; Luigi Bonavina; Mircea Chirica; Ugo Boggi; Emmanuil Pikoulis; Salomone Di Saverio; Philippe Montravers; Goran Augustin; Dario Tartaglia; Enrico Cicuttin; Camilla Cremonini; Bruno Viaggi; Belinda De Simone; Manu Malbrain; Vishal G Shelat; Paola Fugazzola; Luca Ansaloni; Arda Isik; Ines Rubio; Itani Kamal; Francesco Corradi; Antonio Tarasconi; Stefano Gitto; Mauro Podda; Anastasia Pikoulis; Ari Leppaniemi; Marco Ceresoli; Oreste Romeo; Ernest E Moore; Zaza Demetrashvili; Walter L Biffl; Imitiaz Wani; Matti Tolonen; Therese Duane; Sameer Dhingra; Nicola DeAngelis; Edward Tan; Fikri Abu-Zidan; Carlos Ordonez; Yunfeng Cui; Francesco Labricciosa; Gennaro Perrone; Francesco Di Marzo; Andrew Peitzman; Boris Sakakushev; Michael Sugrue; Marja Boermeester; Ramiro Manzano Nunez; Carlos Augusto Gomes; Miklosh Bala; Yoram Kluger; Fausto Catena Journal: World J Emerg Surg Date: 2021-08-09 Impact factor: 5.469