Owens M L, Passaro E, Wilson S E, Gordon H E
Ann Surg. 1977 Jul;186(1):17-21. doi: 10.1097/00000658-197707000-00003.
This study reviews previous reports of peptic ulcer disease in kidney transplant recipients and includes our own experience. Between 1968-1976, 12 transplant centers reported on gastrointestinal complications occurring in 1853 renal transplant recipients. Among these are 52 patients in whom peptic ulcers developed before trnasplantation and 72 patients in whom peptic ulcers developed after transplantation. Included are 21 patients with peptic ulcer from 115 renal transplant recipients at VA Wadsworth Hospital. Patients who were operated upon for peptic ulcer before trnasplant were compared to patients with peptic ulcer before transplant but who were not operated upon. Ulcer recurrence was significantly lower in the operated group p less than .0003. Following transplantation 59 of 68 patients with peptic ulcer disease presented with bleeding or perforation. Mortality was high: 31 deaths in 72 patients (43%). Symptoms usually occurred early, 74% in 6 months, but 19% occurred after one year. The mortality from duodenal, gastric, combined gastric and duodenal and recurrent ulcers did not differ significantly. Elective surgery is indicated for peptic ulcer when demonstrated before or after kidney transplantation.
本研究回顾了此前关于肾移植受者消化性溃疡疾病的报告，并纳入了我们自己的经验。1968年至1976年间，12个移植中心报告了1853例肾移植受者发生的胃肠道并发症。其中有52例患者在移植前发生消化性溃疡，72例患者在移植后发生消化性溃疡。VA沃兹沃思医院115例肾移植受者中有21例患有消化性溃疡。对移植前因消化性溃疡接受手术的患者与移植前患有消化性溃疡但未接受手术的患者进行了比较。手术组的溃疡复发率显著更低，p小于0.0003。移植后，68例消化性溃疡疾病患者中有59例出现出血或穿孔。死亡率很高：72例患者中有31例死亡（43%）。症状通常出现得较早，6个月内出现症状的占74%，但19%在1年后出现。十二指肠溃疡、胃溃疡、胃和十二指肠复合型溃疡以及复发性溃疡的死亡率没有显著差异。肾移植前后确诊为消化性溃疡时，应进行择期手术。
