Development of Encapsulating Peritoneal Sclerosis in Kidney Allograft Recipients: Risk Factors and Clinical Implications

OBJECTIVES: Although bowel obstruction due to encapsulating peritoneal sclerosis (EPS) is a rare complication following kidney transplantation, all our patients were previous peritoneal dialysis (PD) patients. The aim of this study was to investigate the incidence and risk factors for development of bowel obstruction due to EPS in kidney allograft recipients previously treated with PD. METARIAL and METHODS: We retrospectively recruited 31 PD patients who had kidney transplantation between 1999 and 2009. Development of postoperative bowel obstruction due to EPS was further analysed for the risk factors. RESULTS: Four patients (12.9%) developed bowel obstruction due to EPS in post-transplant period (minimum 7 days to maximum 24 months). Three patients underwent surgical adhesiolysis and intestinal resection due to ischemia and one patient in this group lost the graft due to renal graft artery thrombosis during the bowel obstruction period. The fourth was resolved with conservative treatment. PD duration and the number of peritonitis attacks were the statistically significant risk factors for development of bowel obstruction due to EPS (p=0.0018 and p=0.004, respectively). CONCLUSION: Bowel obstruction due to EPS can be seen after kidney transplantation in PD patients and it needs surgical treatment in most cases. PD duration and number of previous peritonitis attacks are the risk factors for post-transplant EPS development