Incidence and outcome of abdominal surgical interventions following lung transplantation--a single center experience.

PURPOSE: Abdominal complications after lung transplantation (LuTx) are associated with a high mortality risk. Aim of the present study was to analyse frequency and outcome of abdominal interventions following LuTx.

METHODS

Retrospective analysis of the requirement of abdominal surgery including data of 754 patients undergoing LuTx at the Hannover Medical School, Germany, between January 2000 and December 2008.

RESULTS

In the course of lung transplantation, 55 patients (7%) were in need of surgical interventions due to abdominal complications. Following LuTx, 35 individuals were operated in 43 cases of emergency indication. The leading diagnosis was bowel perforation (n = 10) with surgery performed 10.4 months after LuTx, although 7 of 10 patients were operated within the first 4 weeks post-transplantation. Emergency interventions were associated with a mortality rate of 28%, 42% thereof after bowel perforation. Elective surgical treatments (n = 31) were diverse and had no influence on mortality.

CONCLUSIONS

Early abdominal complications after LuTx correlate with a high mortality rate. Perforation of the bowel was the leading diagnosis with a severe impact on the outcome. Thus, in cases of an acute abdomen after LuTx, we recommend the broad use of further diagnostic measures as well as an early decision for explorative laparotomy.