Gut Liver.  2012 Jul;6(3):349-354.

Increased Incidence of Endoscopic Erosive Esophagitis in Solid Organ Transplant Recipients

• Kim IS
• Lee H
• Park JC
• Shin SK
• Lee SK
• Lee YC

Abstract

BACKGROUND/AIMS
Solid organ transplant recipients frequently report gastrointestinal symptoms, especially heartburn or dyspepsia. However, the prevalence of endoscopic erosive esophagitis (EE) and associated risk factors after transplantation are unknown. The aim of this study was to determine whether there was a high incidence of endoscopic findings of EE in solid organ transplant recipients.
METHODS
This retrospective case-control study included 256 of 3,152 solid organ transplant recipients who underwent sequential screening upper endoscopic examinations and an equal number of controls.
RESULTS
Forty-four (17.2%) and 16 (6.2%) cases of EE were detected in the solid organ transplant and control groups, respectively (p<0.001). In the multivariate analysis, transplantation was significantly associated with EE (odds ratio [OR], 6.48; 95% confidence interval, 2.74 to 15.35). Factors such as old age (OR, 1.17), the presence of a hiatal hernia (OR, 5.84), an increased duration of immunosuppression (OR, 1.07), and the maintenance administration of mycophenolate mofetil (OR, 4.13) were independently associated with the occurrence of EE in the solid organ transplant recipients.
CONCLUSIONS
A significant increase in the incidence of endoscopically detected EE was observed in solid organ transplant recipients. This increased incidence was associated with the type and duration of the immunosuppressive therapy.

Keyword

Transplantation; Erosive esophagitis; Gastroesophageal reflux; Mycophenolate mofetil; Barrett esophagus

MeSH Terms

Barrett Esophagus
Case-Control Studies
Dyspepsia
Esophagitis
Gastroesophageal Reflux
Heartburn
Hernia, Hiatal
Immunosuppression
Incidence
Mass Screening
Multivariate Analysis
Mycophenolic Acid
Prevalence
Retrospective Studies
Risk Factors
Transplants
Mycophenolic Acid