Gastrointestinal complications of transplant immunosuppression.

At a time when the judicious use of a broad range of immunosuppressive drugs has ensured excellent patient and organ survival rates after kidney transplantation, attention is focusing on strategies to minimize their side effects. Almost all immunosuppressive medications are associated with some form of gastrointestinal (GI) complication (1–6). The majority of these complications fall into one of several general categories: infections, mucosal injury and ulceration, biliary tract diseases, diverticular disease, pancreatitis, and malignancy (Table 1). An understanding of the GI morbidities related to transplantation permits the development of systematic strategies to reduce and manage these disorders. In this article, we provide an overview of the GI complications arising from the use of immunosuppressive medications and review common prophylactic and treatment approaches.