Christopher Young, MD1, Samarth Patel, MD1, Mohammad B. Siddiqui, DO2, Emily Zhang, BA3, Anchalia Chandrakumaran, MD1, Masoud Faridnia, MD1, Jose Roman Hernandez, MD1, Mohammad S. Siddiqui, MD1, George B. Smallfield, MD1
1Virginia Commonwealth University Medical Center, Richmond, VA; 2Virginia Commonwealth University Medical Center, Glen Allen, VA; 3Virginia Commonwealth University School of Medicine, Richmond, VA
Diarrhea is a common complication of liver transplant (LT) frequently attributed to immune suppressive therapy. However, there is a dearth of published literature with regards to etiology, management, and time course of diarrhea in LT recipients. The aim of this study was to describe and compare the etiology of diarrhea both in the first 12 months after transplant and in diarrhea arising later after LT.
This is a retrospective examination of 333 consecutive patients who underwent LT at author's institution. Diarrhea was defined as ≥ 3 loose bowel movements occurring within 24 hours. Charts were reviewed for diagnostic
evaluation of diarrhea, causative agent, and management. Diarrhea was described at intervals of within 12 months post-LT, diarrhea occurring after 12 months post-LT, and diarrhea that occurred during both time intervals.
Risk factors and etiology of diarrhea were analyzed and described.
Results:The mean age of the cohort was 52.4 years, 38.1% were female. Patients were followed for up to 5 years after transplantation. 162 patients (48.6%) developed diarrhea within 5 years of LT. 80 patients (24%) developed diarrhea within 1 year after LT but did not have recurrent episode. 63 patients (18.9%) first developed diarrhea more than 12 months after LT. 19 patients (5.7%) developed diarrhea both during the first year and after 1 year. Clostridium difficile (C. Diff) infection was the most common diagnosis in all 3 groups, with 23(28.8%) occurrences in the early group, 16(26.7%) in the late group, and 5(26.3%) in the early and late group. Nearly half of those patients that developed diarrhea were admitted to the hospital. 37/80 (46.3%) patients with diarrhea within 12 months were admitted. 29/63 (46.0%) patients in the late group were also admitted. 9/19 (47.3%) patients with diarrhea both within 12 months and after required admission. No significant differences in etiology or admission rate between the groups
Diarrhea is common after liver transplant and occurs both early and late following LT. Hospital admissions are also common in both groups of patients. With the high rates of C. diff infection both early and late post-LT, further study of preventative measures are warranted.
Citation: Christopher Young, MD; Samarth Patel, MD; Mohammad B. Siddiqui, DO; Emily Zhang, BA; Anchalia Chandrakumaran, MD; Masoud Faridnia, MD; Jose Roman Hernandez, MD; Mohammad S. Siddiqui, MD; George B. Smallfield, MD. P1515 - DIARRHEA IS COMMON BOTH EARLY AND LATE AFTER LIVER TRANSPLANTATION AND RATES OF C. DIFF. REMAIN ELEVATED. Program No. P1515. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.