The Outcome of Diverticulosis in Kidney Recipients With Polycystic Kidney Disease

• Published in: Transplantation proceedings 2007-05, Vol.39 (4), p.1054-1056
• Main Authors: Pourfarziani, V, Mousavi-Nayeeni, S.-M, Ghaheri, H, Assari, S, Saadat, S.H, Panahi, F, Noorbala, M.-H, Vasei, A, Norouzi, A.-R, Simforoosh, N
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Diverticulum - complications; Diverticulum - genetics; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Kidney Transplantation - physiology; Kidneys; Male; Malformations of the urinary system; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Polycystic Kidney, Autosomal Dominant - complications; Polycystic Kidney, Autosomal Dominant - surgery; Retrospective Studies; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue, organ and graft immunology; Treatment Outcome
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2007.02.007

Abstract Introduction Diverticulosis is a common finding in autosomal-dominant polycystic kidney disease (ADPKD). To avoid the serious complications of diverticulosis after kidney transplantation, some policies have recommended aggressive actions, such as elective colectomy. These policies are not widely agreed upon. This controversy led us to investigate the serious complications and the outcome of diverticulosis in ADPKD kidney recipients to see whether such therapies are justified. Materials and methods From 2002 to 2006, we followed 18 ADPKD kidney recipient patients with barium enema-documented diverticulosis. All subjects were asymptomatic for diverticulosis at the time of transplantation. The mean value ± SD of follow-up duration was 25.4 ± 28.5 months. We documented demographic data, familial history of ADPKD, barium enema findings, and complications as well as graft and patient survivals. Results Hepatic flexure was the most prevalent site for diverticula. The mean (SD) of diverticular count was 6 ± 5.1. Patients with a familial history of ADPKD showed a higher number of diverticular ( P = .01). Diverticulitis occurred in three patients, all of whom died. Conclusion Diverticulitis is a fatal and not rare complication in ADPKD patients. The rate of complications in our study was similar to previous findings, but we observed serious complications even among patients asymptomatic at the time of transplantation. The decision to take aggressive action such as elective colectomy is still a matter of debate that needs further evaluation.