Preventive gastrectomies before kidney transplantations

: Gastroduodenal bleeding or perforation occurs in 3.5 to 60% of renal transplant patients. Mortality ranges from 35 to 75%. Experience with prophylactic gastric surgery is based on 61 patients with chronic hemodialysis, who were prepared for renal transplantation since 1974. History, presence of ulcer disease or hyperchlorhydria were assumed to represent a gastroduodenal risk. All 20 patients with such a risk-factor received prophylactic gastric surgery (high risk: selective gastric vagotomy + hemigastrectomy in 12, low risk: selective proximal vagotomy in 6; truncal vagotomy + drainage in 2 cases). Postoperatively there were no serious complications, no lethality.