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What Are the Unique Considerations in Renal Transplant Patients with Abdominal Pain?

  • Kenneth Potter
  • Jordan B. SchoolerEmail author
Chapter

Abstract

Mortality and morbidity related to renal transplants are relatively uncommon. Many presentations of abdominal pain in the renal transplant patient will be unrelated to the transplant itself. However, immunosuppression may mask symptoms. It also increases the risk of both infectious complications and other medication-related effects. Ultrasound and computed tomography are highly useful in this patient population. Intravenous contrast is likely safe in transplanted kidneys, but caution is advisable in patients with reduced renal function.

Keywords

Renal transplant Immunosuppression Infection Contrast nephropathy Complications 

References

  1. 1.
    Farrugia D, Cheshire J, Begaj I, Khosla S, Ray D, Sharif A. Death within the first year after kidney transplantation--an observational cohort study. Transpl Int. 2014;27:262–70.CrossRefGoogle Scholar
  2. 2.
    Hariharan S, Johnson CP, Bresnahan BA, Taranto SE, McIntosh MJ, Stablein D. Improved graft survival after renal transplantation in the United States, 1988 to 1996. N Engl J Med. 2000;342:605–12.CrossRefGoogle Scholar
  3. 3.
    Fishman JA. Infection in solid-organ transplant recipients. N Engl J Med. 2007;357:2601–14.CrossRefGoogle Scholar
  4. 4.
    Fontana F, Gianni C. Acute pancreatitis associated with everolimus after kidney transplantation: a case report. BMC Nephrol. 2016;17:163–6.CrossRefGoogle Scholar
  5. 5.
    Haberal M, Boyvat F, Akdur A, Kirnap M, Özçelik Ü, Yarbuğ KF. Surgical complications after kidney transplantation. Exp Clin Transplant. 2016;14:587–95.PubMedGoogle Scholar
  6. 6.
    Moreno CC, Mittal PK, Ghonge NP, Bhargava P, Heller MT. Imaging complications of renal transplantation. Radiol Clin N Am. 2016;54:235–49.CrossRefGoogle Scholar
  7. 7.
    Briggs JD. Causes of death after renal transplantation. Nephrol Dial Transplant. 2001;16:1545–9.CrossRefGoogle Scholar
  8. 8.
    Dimitroulis D, Bokos J, Zavos G, Nikiteas N, Karidis NP, Katsaronis P, et al. Vascular complications in renal transplantation: a single-center experience in 1367 renal transplantations and review of the literature. Transplant Proc. 2009;41:1609–14.CrossRefGoogle Scholar
  9. 9.
    Thongprayoon C, Cheungpasitporn W, Edmonds PJ, Thamcharoen N. Perforated jejunal diverticulum in the use of mycophenolate mofetil. N Am J Med Sci. 2014;6:599–600.CrossRefGoogle Scholar
  10. 10.
    Dierickx D, Habermann TM. Post-transplantation lymphoproliferative disorders in adults. N Engl J Med. 2018;378:549–62.CrossRefGoogle Scholar
  11. 11.
    Cheungpasitporn W, Thongprayoon C, Mao MA, Mao SA, D’Costa MR, Kittanamongkolchai W, et al. Contrast-induced acute kidney injury in kidney transplant recipients: a systematic review and meta-analysis. World J Transplant. 2017;7(1):81–8.CrossRefGoogle Scholar
  12. 12.
    Haider M, Yessayan L, Venkat KK, Goggins M, Patel A, Karthikeyan V. Incidence of contrast-induced nephropathy in kidney transplant recipients. Transplant Proc. 2015;47:379–83.CrossRefGoogle Scholar
  13. 13.
    Wilhelm-Leen E, Montez-Rath ME, Chertow G. Estimating the risk of radiocontrast-associated nephropathy. J Am Soc Nephrol. 2017;28:653–9.CrossRefGoogle Scholar
  14. 14.
    McDonald RJ, McDonald JS, Carter RE, Hartman RP, Katzberg RW, Kallmes DF, et al. Intravenous contrast material exposure is not an independent risk factor for dialysis or mortality. Radiology. 2014;273:714–25.CrossRefGoogle Scholar
  15. 15.
    Hinson JS, Ehmann MR, Fine DM, Fishman EK, Toerper MF, Rothman RE, et al. Risk of acute kidney injury after intravenous contrast media administration. Ann Emerg Med. 2017;69:577–586.e4.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Anesthesiology and Perioperative MedicinePenn State Hershey Medical CenterHersheyUSA
  2. 2.Department of Emergency MedicinePenn State Hershey Medical CenterHersheyUSA

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