SIGMOID DIVERTICULAR PERFORATION COMPLICATING LUNG TRANSPLANTATION

We present three lung transplant recipients who had sigmoid colonic di verticular perforation within 4 weeks of transplantation, giving an ov erall incidence of 8.6% (3 of 35) in our population. Our cases are unu sual because they all occurred in the early posttransplantation period and because the incidence of perforation is substantially higher than that reported in other transplant populations. The reason for the app arent increased incidence of perforation in our lung transplant recipi ents is unclear, but it is likely related to the short follow-up perio d, intense posttransplantation immunosuppression, perioperative hypope rfusion, and increased intraluminal pressure from the use of narcotics and bowel stimulants. We discuss these potential causes and comment o n preventive measures being undertaken at our program.