Acute colonic pseudo-obstruction (Ogilvie’s syndrome) after renal transplantation

Background: Acute colonic pseudo-obstruction (Ogilvie’s syndrome) in the immunosuppressed patient is associated with increased morbidity and mortality. Renal transplant recipients possess several comorbidities that increase the risk of acute pseudo-obstruction of the colon. The aims of this study were to present our experience with this syndrome and to evaluate the potentiating factors in these patients. A review of the literature for pseudo-obstruction following renal transplantation is presented. Methods: Seven patients who developed Ogilvie’s syndrome were identified in a retrospective review of 550 kidney-only transplants. Pretransplant data, potential risk factors, presentation, management, and outcome details were retrieved. The medical literature was reviewed using Medline. Results: Seventy-eight patients with Ogilvie’s syndrome in the early posttransplant period have been reported. The associated morbidity and mortality was heightened in this immunocompromised population. Obese transplant recipients (body mass index >30 kg/m2) were at significantly increased risk for developing this syndrome. Conclusion: A broad armamentarium of treatment options is available, but the key to successful resolution lies in early recognition.