{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T08:45:26Z","timestamp":1764060326240},"reference-count":0,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[1999,7,1]],"date-time":"1999-07-01T00:00:00Z","timestamp":930787200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1999,7]]},"abstract":"<jats:title>Abstract.<\/jats:title><jats:p>With advances in heart transplantation, a growing number of recipients are at risk of developing gastrointestinal disease. We reviewed our experience with gastrointestinal disease in 92 patients undergoing 93 heart transplants. All had follow\u2010up, with the median time 4.8 years (range 0.5\u20139.6 years). During the period of the study we progressively adopted a policy of low immunosuppression aiming toward monotherapy with cyclosporine. Nineteen patients (20.6%) developed 28 diseases related to the gastrointestinal tract. Thirteen patients required 18 surgical interventions, five as emergencies: closure of a duodenal ulcer, five cholecystectomies (one with biliary tract drainage), a sigmoid resection for a diverticulitis with a colovesical fistula, a colostomy followed by a colostomy takedown for an iatrogenic colon perforation, appendectomy, two anorectal procedures, and six abdominal wall herniorrhaphies. At the onset of gastrointestinal disease, 8 patients were on standard triple\u2010drug immunosuppression, all of them within 6\u00a0months of transplantation; 13 were on double\u2010drug immunosuppression; and 7 were on cyclosporine alone. All the patients with perforations\/fistulas were on steroids. Among the 11\u00a0infectious or potentially infectious diseases, 10 were on triple\u2010 or double\u2010drug immunosuppression. One death, a patient who was on triple\u2010drug immunosuppression, had a postmortem diagnosis of necrotic and hemorrhagic pancreatitis. Except for an incisional hernia following a laparoscopic cholecystectomy, there was no morbidity and, importantly, no septic complications. We concluded that a low immunosuppression policy is likely to be responsible for the low morbidity and mortality of posttransplant gastrointestinal disease, with a lower incidence of viscous perforation\/fistula and infectious gastrointestinal disease.<\/jats:p>","DOI":"10.1007\/pl00012363","type":"journal-article","created":{"date-parts":[[2006,2,17]],"date-time":"2006-02-17T16:26:39Z","timestamp":1140193599000},"page":"650-656","source":"Crossref","is-referenced-by-count":36,"title":["Gastrointestinal Disease following Heart Transplantation"],"prefix":"10.1002","volume":"23","author":[{"given":"Xavier M.","family":"Mueller","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery Centre Hospitalier Universitaire Vaudois rue du Bugnon 46 CH\u20101011 Lausanne Switzerland<!--<country1>CH<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hendrick T.","family":"Tevaearai","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Centre Hospitalier Universitaire Vaudois rue du Bugnon 46 CH\u20101011 Lausanne Switzerland<!--<country1>CH<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Stumpe","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Centre Hospitalier Universitaire Vaudois rue du Bugnon 46 CH\u20101011 Lausanne Switzerland<!--<country1>CH<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Hurni","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Centre Hospitalier Universitaire Vaudois rue du Bugnon 46 CH\u20101011 Lausanne Switzerland<!--<country1>CH<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Ruchat","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Centre Hospitalier Universitaire Vaudois rue du Bugnon 46 CH\u20101011 Lausanne Switzerland<!--<country1>CH<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam P.","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Centre Hospitalier Universitaire Vaudois rue du Bugnon 46 CH\u20101011 Lausanne Switzerland<!--<country1>CH<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Seydoux","sequence":"additional","affiliation":[{"name":"Department of Cardiology Centre Hospitalier Universitaire Vaudois rue du Bugnon 46 CH\u20101011 Lausanne Switzerland<!--<country1>CH<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean\u2010Jacques","family":"Goy","sequence":"additional","affiliation":[{"name":"Department of Cardiology Centre Hospitalier Universitaire Vaudois rue du Bugnon 46 CH\u20101011 Lausanne Switzerland<!--<country1>CH<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ludwig K.","family":"von Segesser","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Centre Hospitalier Universitaire Vaudois rue du Bugnon 46 CH\u20101011 Lausanne Switzerland<!--<country1>CH<\/country1>-->"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1999,7]]},"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/PL00012363.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/PL00012363\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/PL00012363","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T16:56:31Z","timestamp":1703696191000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/PL00012363"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,7]]},"references-count":0,"journal-issue":{"issue":"7","published-print":{"date-parts":[[1999,7]]}},"alternative-id":["10.1007\/PL00012363"],"URL":"https:\/\/doi.org\/10.1007\/pl00012363","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[1999,7]]}}}