Abdominal Complications After Lung Transplantation in a Brazilian Single Center H.F. Costa, F.P. dos Reis, O. Gomes-Junior, L.M. Fernandes, L.G. Abdalla, S.V. Campos, R.H.O.B. Teixeira, M.N. Samano*, and P.M. Pêgo-Fernandes Thoracic Surgery Division of Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil ABSTRACT Surgical and nonsurgical abdominal complications have been described after lung trans- plantation. However, there is limited data on this event in this population. The objective of this study was to analyze the incidence of abdominal complications in patients undergoing lung transplantation at the Heart Institute of the Faculty of Medicine, University of São Paulo (InCor-HCFMUSP) between the years 2003 and 2016. The main causes of abdominal com- plications were inflammatory acute abdomen (7 patients; 14%), obstructive acute abdomen (9 patients; 18%), gastroparesis (4 patients; 8%), distal intestinal obstruction syndrome (4 patients; 8%), perforated acute abdomen (7 patients; 14%), cytomegalovirus (CMV; 6 patients; 12%), and other reasons (12 patients; 26%). Separating these patients according to Clavien-Dindo classification, we had 21 patients (43%) with complications grade II, 4 patients (8%) with complications grade IIIa, 7 patients (14%) with grade IIIb complications, 7 patients (14%) with grade IV complications, and 10 patients (21%) with grade complications V. In conclusion, abdominal disorders are seriously increased after lung transplantation and correlate with a high mortality. Early abdominal surgical complication has worse prognosis. L UNG transplantation has become the standard therapy for the treatment of eligible patients with terminal pulmonary disease. The last record published by the Inter- national Society for Heart and Lung Transplantation (ISHLT) Registry Report of 2015 showed that 51,440 lung transplantations have been performed up to June 2014 [1]. Surgical and nonsurgical abdominal complications have been described after lung transplantation. However, there is limited data on this event in this population. The work related to this issue shows that they are an important source of morbidity and mortality in lung transplant recipients [2e6], requiring early diagnosis to assess risk factors. The objective of this study was to analyze the incidence of abdominal complications in patients undergoing lung transplantation at the Heart Institute of the Faculty of Medicine, University of São Paulo (InCor-HCFMUSP), between the years 2003 and 2016. MATERIAL AND METHODS This was a retrospective study including all patients undergoing lung transplantation from August 2003 to August 2016 at a single center in the InCor-HCFMUSP. Patient records in our database were analyzed. The patients were followed up after the transplantation with the aim of identifying abdominal complications, defined as any postoperative condition affecting the gastrointestinal (GI) tract, liver, pancreas, or biliary tract in need of drug therapy, surgery, or endoscopic or radiological testing, and with 2 according to the Clavien-Dindo classification (Appendix A) [7]. Abdominal complications were classified as early (up to 30 days after transplantation) or late (more than 30 days after transplantation). We performed statistical analyzes using SPSS 18.0 (SPSS Inc, Chicago, Ill, United States) with a confidence interval of 95% and .05 significance level. For data comparison with normal distribution we carried out test samples Student t. The Mann-Whitney test was used for the variables that were not normally distributed. For qualitative variables in 2  2 tables we used Fisher chi-square or exact tests. The results were expressed as mean and standard error of the mean or median and interquartile range for variables that were not normally distributed. *Address correspondence to Marcos Naoyuki Samano, Uni- versity of São Paulo, Rua Enéas de Carvalho Aguiar, 44 e Bloco II, 2  andar, sala 9, São Paulo/SP, CEP 05403-000 Brazil. E-mail: marcos.samano@incor.usp.br 0041-1345/17 http://dx.doi.org/10.1016/j.transproceed.2017.03.002 ª 2017 Elsevier Inc. All rights reserved. 230 Park Avenue, New York, NY 10169 878 Transplantation Proceedings, 49, 878e881 (2017)