Acid blocking medication usage pre and post liver transplantation

Background: Terminal liver disease is associated with upper gastrointestinal (GI) pathology. Following liver transplantation (LT), some immunosuppressive agents can cause GI complications. Methods: We investigated the use of acid blocking medication (ABM) pre and post transplant in a series of 467 consecutive LTs in 402 individuals, which were performed from 1998 to 2001 at our center. Results: A total of 41% of patients were given ABM pretransplant. All patients received proton pump inhibitors (PPIs) for 100 days per protocol. After a median follow up of 5 (range 1-8.1) years for 339 evaluate transplants, 64% of patients received ABM for peptic ulcer disease (n = 28), GERD (n = 50), dyspepsia/gastritis (n = 30), recurrent liver cirrhosis (n = 15) and prophylaxis if patients were maintained on steroids (n = 21), MMF (n = 17), Sirolimus (n = 9) or received biphosphonates for osteoporosis (n = 22). In a minority of cases no clear indication could be found. Conclusions: Upper GI diseases are common complications after LT and many LT recipients require long term ABM.