K. Lang et al., Outcome of gastrointestinal complications after liver transplantation for familial amyloidotic polyneuropathy, SC J GASTR, 35(9), 2000, pp. 985-989
Background: Gastrointestinal disturbances are important prognostic factors
for mortality and morbidity after liver transplantation for familial amyloi
dotic polyneuropathy (FAP). However, the impact of liver transplantation on
malabsorption and bacterial small-bowel contamination has not been evaluat
ed. Methods: Twenty-three FAP patients were available for the study. They w
ere examined for gastrointestinal disturbances as a part of the evaluation
for liver transplantation for FAP. Bile acid malabsorption was diagnosed wi
th the [Se-75]-homocholic acid taurate (SeHCAT) test; fat malabsorption by
measuring faecal fat excretion; and bacterial small-bowel contamination wit
h the hydrogen breath test (HBT). Results: No significant improvement of ma
labsorption test results were noted from the pretransplant evaluation 8 mon
ths (range, 2-20 months) before transplantation to the post-transplant eval
uation performed a median of 20 months (range, 9-62 months)after the proced
ure. The SeHCAT test result became abnormal in two patients and normal in o
ne, and changes in the test correlated with the time the patients were wait
ing for transplantation. Faecal fat excretion after transplantation correla
ted with duration of the disease and with fat excretion before transplantat
ion. A significantly increased fat excretion was noted at the post-transpla
nt evaluation. A change in HBT result was noted in only one patient, in who
m the test result became normal; pre-transplant Values correlated with thos
e obtained after transplantation. Conclusion: For most FAP patients no impr
ovement in gastrointestinal function was found after transplantation. The f
inding underlines the importance of an early transplantation before the pat
ients have developed gastrointestinal dysfunction.