Early abdominal complications following heart and heart-lung transplantation

Heart transplant has become an accepted treatment for patients with end-stage (terminal) heart disease; survival rate is 79 percent at one year, and 66 percent at five years. Although graft rejection is the main concern in the postoperative period, many patients also develop abdominal problems. A review is presented of patients who developed abdominal complications following heart or heart-lung transplantation. Over a 10-year period, a total of 429 patients received transplants; of these, 41 patients (9.5 percent) developed abdominal complaints within one month after surgery. Twenty patients underwent abdominal surgery for these complications. Development of abdominal symptoms reduced survival, but not significantly. The most common complication was pancreatitis (inflammation of the pancreas usually due to damage to the biliary system) occurring in 10 patients. Other complications included peptic ulcer (loss of the lining of the stomach or small intestine); pseudo-obstruction of the intestine; perforation of the colon; and small bowel obstruction. Laparotomy (abdominal surgery), when necessary, was well tolerated. It is concluded that prompt diagnosis and treatment of abdominal complications following heart or heart-lung transplant is necessary. The risk associated with laparotomy used to establish a definite diagnosis is less than the risk major abdominal infection in a patient with a weakened immune system. (Treatment with drugs to suppress the immune system to avoid rejection of the transplanted organ is standard procedure in these patients.) (Consumer Summary produced by Reliance Medical Information, Inc.)