Treatment of Peptic Ulcer Disease in the Renal Transplant Patient

Abstract

Between 1968-1976, 12 transplant centers reported on gastrointestinal complications in 1853 renal transplant recipients. There were 52 patients with peptic ulcers developed before transplantation and 72 patients with peptic ulcers developed after transplantation. Included are 21 patients with peptic ulcer from 115 renal transplant recipients at VA Wadsworth Hospital. Patients operated on for peptic ulcer before transplant were compared to patients with peptic ulcer before transplant but who were not operated on. Ulcer recurrence was significantly lower in the operated group P < .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 mo., but 19% occurred after 1 yr. 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.