Journal List > J Korean Soc Transplant > v.23(3) > 1034294

J Korean Soc Transplant. 2009 Dec;23(3):233-236. Korean.
Published online December 31, 2009.  https://doi.org/10.4285/jkstn.2009.23.3.233
Copyright © 2009 The Korean Society for Transplantation
Clinical Characteristics of Acute Appendicitis in Kidney Transplant Recipients
Han Hee Lee, M.D.,1 Jung Jun Lee, M.D.,1,2 Man Ki Ju, M.D.,1,2 Myoung Soo Kim, M.D.,1,2 Kyu Ha Huh, M.D.,1,2 Eyi Sang Yoon, M.D.,1,2 Dong Jin Joo, M.D.,1,2 Soo Jin Kim, M.D.,1,2 Soon Il Kim, M.D.,1,2 and Yu Seun Kim, M.D.1,2
1Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
2The Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author (Email: ysms91@yuhs.ac )
Received November 09, 2009; Accepted November 26, 2009.

Abstract

Background

Appendicitis is a common surgical disease. There are many problems for the early diagnosis of acute appendicitis in kidney transplant patients; differential diagnosis for acute rejection, limitation in imaging study, problems of immunosuppressant and non-characteristic symptoms.

Methods

We reviewed medical records and transplant database of 2,947 renal transplant patients between April, 1979 and September, 2009 retrospectively. Patient's characteristics, diagnostic methods for appendicitis and operative/postoperative progresses were analyzed.

Results

Of the 2,947 renal transplant patients, there were 15 (0.51%, 13 males and 2 females) acute appendicitis patients. Mean age at the diagnosis of appendicitis was 37.2±10.1 years. Fourteen (93.3%) patients suffered from prodromal symptom, such as abdominal pain, direct or rebound tenderness, nausea and vomiting. There were 12 (80%) patients with leukocytosis (WBC count >10,000/µL). Computed tomography scans were performed in 5 (33.4%) patients for diagnosis. Laparoscopic appendectomies were applied for 8 (53.4%) patients. In pathologic diagnosis, 2 cases were reported as 'non pathologic diagnosis' complications occurred in 2 patients as remnant appendicitis and pancreatitis. However, there was no patient with mortality and renal failure during the hospitalization.

Conclusions

There were no significant differences between the transplant patients and the general population in the incidence, clinical features, diagnosis and postoperative progresses of acute appendicitis.

Keywords: Acute appendicitis; Kidney transplantation; Acute abdomen

Tables


Table 1
Incidence of acute appendicitis by demographics
Click for larger image


Table 2
Clinical characteristics of acute appendicitis after kidney transplantation
Click for larger image

References
1. Wright FH Jr, Abu-Yousef MM, Smith JL, Georgi B, Corry RJ. Appendicitis in a transplant patient. Transplantation 1988;45:1159.
2. Humes DJ, Simpson J. Acute appendicitis. BMJ 2006;333:530–534.
3. Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 1990;132:910–925.
4. Hegde S, Moghal NE, Coulthard MG. Acute appendicitis occurring immediately post-renal transplant. Pediatr Transplant 2006;10:119–120.
5. Talwalkar NC, Javali D, Venkatesh K, Iyer S, Venkatesh M, Joshi UB. Acute appendicitis mistaken as acute rejection in renal transplant recipients. J Postgrad Med 1994;40:39–40.
6. Lao A, Bach D. Colonic complications in renal transplant recipients. Dis Colon Rectum 1988;31:130–133.
7. Cartwright SL, Knudson MP. Evaluation of acute abdominal pain in adults. Am Fam Physician 2008;77:971–978.
8. Archibald SD, Jirsch DW, Bear RA. Gastrointestinal complications of renal transplantation. 2. The colon. Can Med Assoc J 1978;119:1301–1305. 1309.
9. Bardaxoglou E, Maddern G, Ruso L, Siriser F, Campion JP, Poqamp P, et al. Gastrointestinal surgical emergencies following kidney transplantation. Transpl Int 1993;6:148–152.
10. Flanigan RC, Reckard CR, Lucas BA. Colonic complications of renal transplantation. J Urol 1988;139:503–506.
11. Larner AJ. The aetiology of appendicitis. Br J Hosp Med 1988;39:540–542.
12. Chan MK, Wilcox DT, Trompeter RS. Acute appendicitis in children after renal transplantation. Arch Dis Child 1999;81:372.
13. Rao PM, Boland GW. Imaging of acute right lower abdominal quadrant pain. Clin Radiol 1998;53:639–649.
14. Bickell NA, Aufses AH Jr, Rojas M, Bodian C. How time affects the risk of rupture in appendicitis. J Am Coll Surg 2006;202:401–406.
15. Sauerland S, Lefering R, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev 2004;18:CD001546.
16. Blomqvist PG, Andersson RE, Granath F, Lambe MP, Ekbom AR. Mortality after appendectomy in Sweden, 1987-1996. Ann Surg 2001;233:455–460.
TOOLS
Similar articles

A Prediction Model Development on Quality of Life in Kidney Transplant Recipients

Acute T cell-mediated rejection after administration of the BNT162b2 mRNA COVID-19 vaccine in a kidney transplant recipient: a case report

Swine Influenza A (H1N1) Infection in Renal Transplant Recipients

A Pilot Study of Calcineurin Inhibitors (CNIs) and Steroid Avoidance Immunosuppressive Protocol among Living Donor Kidney Transplant Recipients

Diagnostic performance of multidetector computed tomography for symptomatic lymphoceles in kidney transplant recipients