1986 Volume 77 Issue 7 Pages 1115-1120
A study was made on the cases of gastrointestinal (GI) bleeding after renal transplantation.
Of 78 cases of renal transplantation, 7 cases (9%) developed GI bleeding (gastric ulcer 3 cases, duodenal ulcer 4 cases).
The incidence of GI bleeding was 2 out of 43 cases (5%) of living-related kidney transplantation and 5 out of 35 cases (14%) of cadaveric kidney transplantation.
These seven patients consisted of 4 men and 3 women, their age ranging from 11 to 42 years (average 34 years).
The GI bleeding occurred within 3 weeks after transplantation in 6 patients suffering from acute tubular necrosis (ATN).
Three patients treated with ciclosporin (Cs) showed constantly high serum Cs levels before the onset of GI bleeding.
Cimetidine was administered to all 7 GI bleeding cases and consequently the bleeding was stopped in 3 cases. In 3 out of the remaining 4 cases, the bleeding was stopped by endoscopic hemostasis procedure.
One patient who received gastrectomy died from sepsis caused by postoperative failure of the suture. As for 1 case in which endoscopic hemostasis was attained, the patient died of DIC and sepsis later. The other 5 cases achieved complete social rehabilitations, maintaing good renal functions.
Insufficient graft-function (ATN) and high Cs levels could be risk factors for GI bleeding.
In case of GI bleeding after renal transplantation, adequate treatments such as cimetidine administration and endoscopic hemostasis procedure are important.
