Summary
From December 1964 to June 1980, 569 kidney allotransplants were performed in 524 patients at the University Hospital in Zurich. Necrokidneys were used exclusively. Twelve of these patients exhibited severe colonic complications: four perforations (1 perforated diverticulitis of the sigmoid, 1 perforation of the cecum during cytomegalovirus infection, 2 cases of ischemic colitis), 5 cases of ischemic colitis without perforation, and 3 patients with erosive colitis. In 9 of the 12 patients, hypotonic episodes were noted 4–17 days previously. The 2 % complication rate in our patients is comparable with the mean rate of complications mentioned in the literature (2.4 %). The lethality of 75 % also corresponds with the results of other authors. The most important pathogenetic factor for colonic complications is ischemia; prevention of hypotonic episodes after renal transplantation is therefore mandatory.
Zusammenfassung
Vom Dezember 1964 bis Ende Juni 1980 wurden im Universitätsspital Zürich bei 524 Patienten total 596 Nierenallotransplantationen durchgeführt unter ausschließlicher Verwendung von Nieren Frischverstorbener. Bei einer Nachkontrollzeit von minimum 1\({\raise0.5ex\hbox{$\scriptstyle 1$}\kern-0.1em/\kern-0.15em\lower0.25ex\hbox{$\scriptstyle 2$}}\) Jahren wurden bei 12 Patienten schwere Colonkomplikationen festgestellt. Sie umfassen 4 Perforationen (eine Sigmadiverticulitis, 1 Cytomegalieulcus des Coecums, 2 ischämische Colitiden), 5 Fälle von ischämischer Colitis ohne Perforation und 3 Patienten mit „erosiver Colitis”, die aber ebenfalls ischämisch gedeutet werden muß. Bei 9 der 12 Patienten war der Colonkomplikation eine hypotone Phase von 4–17 Tage vorausgegangen. Die Häufigkeit der Komplikation von 2 % in unserem Krankengut ist mit der mittleren Komplikationsrate der Literatur von 2,4 % vergleichbar. Auch die Letalität von 75 % entspricht derjenigen anderer Berichte. Der wichtigste ursächliche Faktor der Colonkomplikationen ist die Ischämie; die Verhütung von hypotonen Phasen nach Nierentransplantation ist daher wichtig.
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Mona, D., Largiadèr, F., Binswanger, U. et al. Colonkomplikationen nach Nierentransplantation. Langenbecks Arch Chiv 357, 141–150 (1982). https://doi.org/10.1007/BF01237460
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DOI: https://doi.org/10.1007/BF01237460