Gastroparesis following kidney/pancreas transplant

• Published in: Clinical transplantation Vol. 18; no. 3; pp. 306 - 311
• Main Authors: Cashion, AK, Holmes, SL, Hathaway, DK, Gaber, AO
• Format: Journal Article
• Language: English
• Published: Oxford, UK Munksgaard International Publishers 01.06.2004; Blackwell
• Subjects: Adult; Biological and medical sciences; Cardiology. Vascular system; diabetes; Diabetes Mellitus - physiopathology; Diabetes Mellitus - surgery; Dialysis; Electrodiagnosis - methods; electrogastrography; Female; Gastrointestinal Agents - therapeutic use; gastroparesis; Gastroparesis - drug therapy; Gastroparesis - etiology; Gastroparesis - physiopathology; General aspects; Humans; Kidney Failure, Chronic - physiopathology; Kidney Failure, Chronic - surgery; Kidney Failure, Chronic - therapy; Kidney Transplantation - adverse effects; kidney/pancreas transplantation; Male; Medical sciences; Middle Aged; Myoelectric Complex, Migrating - physiology; Pancreas Transplantation - adverse effects; Pilot Projects; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Endocrinopathy; Diabetes mellitus; Transplantation; Homotransplantation; electrogastrography; Kidney; Treatment; Urinary system; Combined surgery; Graft; Anesthesia; Circulatory system; Cardiology; Pancreas; diabetes; gastroparesis; kidney/pancreas transplantation
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/j.1399-0012.2004.00167.x

:  This pilot study examined associations among patterns of gastric myoelectrical activity, symptoms of gastroparesis, years of diabetes, months of dialysis, and use of gastrointestinal medications in gastroparetic kidney‐pancreas (KP) transplant recipients. Electrogastrography (EGG) and gastric symptom data were obtained from 42 transplant recipients before and after transplant (6, 12, and 24 months). Recipients were 38 ± 7 yr of age, 88% Whites, and 60% male; 97% had hypertension. All had functioning grafts post‐transplant (mean creatinine, 1.59 ± 0.66 mg/dL, and serum glucose 91.97 ± 24.92 mg/dL). Sixteen subjects had normal EGG (2.7–3.2 cycles per minute, cpm); two were tachygastric (>3.2 cpm) at all time points; one remained bradygastric (<2.7 cpm) throughout the study period. Following transplant, symptoms lessened and were associated with 6‐month normalization of EGG (r = 0.41, p = 0.02). A small change in the percentage of patients with normal EGG was observed from baseline to 24 months (67% vs. 69% respectively); however, there was a shift from bradygastria (29% to 15% respectively) to tachygastria (5% to 15% respectively). Prescribed prokinetic and antisecretory medications use increased over the study period from 13 (31%) subjects at baseline to 32 (86%) at 6 months; 21 (78%) at 12 months; and 12 (92%) at 24 months. Although symptoms diminish following transplant, gastroparesis remains a significant problem for transplant patients. Normalization of EGG and shifts from bradygastria to tachygastria occur post‐transplant. Our results suggest that serial EGGs and frequent assessment of symptoms can be used to follow gastroparesis in KP recipients.