Gastrointestinal bleeding after liver transplantation

Javier Tabasco-Minguillán, Ashok Jain, Mangala Naik, Kelly M. Weber, William Irish, John J. Fung, Jorge Rakela, Thomas E. Starzl

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

To investigate the causes of gastrointestinal bleeding (GIB) and its impact on patient and graft survival after orthotopic liver transplantation (OLTx), the first 1000 consecutive OLTx using tacrolimus were studied. Our patient population consisted of 834 adults. The bleeding episodes of patients with GIB (n=74) were analyzed, and patients without GIB (n=760) were used as controls. The mean age, gender, and United Network for Organ Sharing status were similar in both groups. Endoscopy was done in 73 patients with GIB and yielded a diagnosis in 60 patients (82.2%): 39 with a single, and 21 with multiple GIB episodes. In the remaining 13 patients (17.8%), the bleeding source was not identified. Of 92 GIB episodes with endoscopic diagnoses, ulcers (n=25) were the most common cause of bleeding, followed by enteritis (n=24), portal hypertensive lesions (n=15), Roux-en-Y bleeds, and other miscellaneous events (n=28). The majority (73%) of the GIB episodes occurred during the first postoperative trimester. The patient and graft survival rates were statistically lower in the GIB group compared with the control group. The adjusted relative risk of mortality and graft failure was increased by bleeding. In summary, the cumulative incidence of GIB was 8.9%. Endoscopy identified the source of GIB in most cases. Ulcers were the most common cause of GIB after OLTx. The onset of GIB after OLTx was an indicator of decreased patient and graft survival.

Original languageEnglish (US)
Pages (from-to)60-67
Number of pages8
JournalTransplantation
Volume63
Issue number1
DOIs
StatePublished - Jan 15 1997

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Liver Transplantation
Hemorrhage
Graft Survival
Endoscopy
Ulcer
Enteritis
Tacrolimus
First Pregnancy Trimester
Survival Rate

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Tabasco-Minguillán, J., Jain, A., Naik, M., Weber, K. M., Irish, W., Fung, J. J., ... Starzl, T. E. (1997). Gastrointestinal bleeding after liver transplantation. Transplantation, 63(1), 60-67. https://doi.org/10.1097/00007890-199701150-00012
Tabasco-Minguillán, Javier ; Jain, Ashok ; Naik, Mangala ; Weber, Kelly M. ; Irish, William ; Fung, John J. ; Rakela, Jorge ; Starzl, Thomas E. / Gastrointestinal bleeding after liver transplantation. In: Transplantation. 1997 ; Vol. 63, No. 1. pp. 60-67.
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Tabasco-Minguillán, J, Jain, A, Naik, M, Weber, KM, Irish, W, Fung, JJ, Rakela, J & Starzl, TE 1997, 'Gastrointestinal bleeding after liver transplantation', Transplantation, vol. 63, no. 1, pp. 60-67. https://doi.org/10.1097/00007890-199701150-00012

Gastrointestinal bleeding after liver transplantation. / Tabasco-Minguillán, Javier; Jain, Ashok; Naik, Mangala; Weber, Kelly M.; Irish, William; Fung, John J.; Rakela, Jorge; Starzl, Thomas E.

In: Transplantation, Vol. 63, No. 1, 15.01.1997, p. 60-67.

Research output: Contribution to journalArticle

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AU - Tabasco-Minguillán, Javier

AU - Jain, Ashok

AU - Naik, Mangala

AU - Weber, Kelly M.

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AU - Fung, John J.

AU - Rakela, Jorge

AU - Starzl, Thomas E.

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Tabasco-Minguillán J, Jain A, Naik M, Weber KM, Irish W, Fung JJ et al. Gastrointestinal bleeding after liver transplantation. Transplantation. 1997 Jan 15;63(1):60-67. https://doi.org/10.1097/00007890-199701150-00012