Liver transplant versus non-liver transplant patients underwent appendectomy with presumed diagnosis of acute appendicitis: Case-control study

BACKGROUND: This study aims to compare liver transplant and non-liver transplant patients who underwent appendectomy with a presumed diagnosis of acute appendicitis.
METHODS: Demographic and clinicopathological features of 13 liver transplant recipients (transplant group) who underwent posttransplant appendectomy with a presumed diagnosis of acute appendicitis were compared with the features of 52 non-liver transplant patients (non-transplant group). They underwent appendectomy with a presumed diagnosis of acute appendicitis during the same time period. The transplant group was matched at random in a 1: 4 ratio with the non- transplant group. While the continuous variables were compared using the Mann Whitney-U test, categorical variables were compared with Fisher’s exact test. A p-value of less than 0.05 was considered statistically significant.
RESULTS: A total of 65 patients aged between one year and 84 years were included in this study. While the age of the 52 patients (32 male and 20 female) in the non- transplant group ranged from 17 years to 84 years, the age of the 13 patients (nine male and four female) in the transplant group ranged from one year to 64 years. Statistically significant differences were noted between both groups concerning WBC (p=0.002), neutrophil (p=0.002), lymphocyte (p=0.032), platelets (p=0.032), RDW (p=0.001), CRP (p=0.009), PNR (p=0.042), WNR (p=0.03), and appendiceal length (p<0.001). The negative appendectomy rate was relatively higher in transplant than the non-transplant group but this difference was not statistically significant (30.8% vs. 21.2%; p=0.477). Perforated acute appendicitis occurred more frequently in the transplant group; however, this difference was not statistically significant (30.8% vs. 9.6%; p=0.070).
CONCLUSION: WBC and neutrophil were lower in the LT group; however, the CRP and RDW were higher in the LT group. Further, perforation and negative appendectomy rates were higher in the LT group, although this difference was not statistically significant.

Akut apandisit ön tanýsý ile apendektomi yapýlan karaciðer transplantlý ve transplant dýþý hastalarýn karþýlaþtýrýlmasý: Olgu kontrol çalýþmasý

AMAÇ: Bu çalýmanýn amacý akut apandisit ön tanýsýyla apendektomi olmuþ karaciðer transplantlý ve transplant dýþý hastalarý karþýlaþtýrmaktýr.
GEREÇ VE YÖNTEM: Posttransplant dönemde akut apandisit ön tanýsýyla apendektomi yapýlan 13 karaciðer transplantlý hasta (transplant grubu) ile ayný dönemde apendektomi olmuþ transplant dýþý 52 hasta (non-transpalnt grubu) demografik ve klinikopatolojik özellikler yönünden karþýlaþtýrýldý. Transplant ve non-transplant gruplar 1: 4 rastgele eþleþtirme yöntemi kullanýlarak oluþturuldu. Devamlý deðiþkenlerin karþýlaþtýrýlmasýnda Mann-Whitney U-testi kullanýlýrken kategorik deðiþkenlerin karþýlaþtýrýlmasýnda Fisher kesin testi kullanýldý. P deðeri <0.05 istatistiksel anlamlýlýk sýnýrý olarak kabul edildi.
BULGULAR: Bu çalýþmaya yaþlarý 1 ile 84 yýl arasýnda deðiþen toplam 65 hasta alýndý. Non-transplant grubundaki 52 hastanýn (32 erkek ve 20 kadýn) 17 ile 84 yýl arasýnda deðiþirken transplant grubundaki 13 hastanýn (9 erkek ve 4 kadýn) yaþlarý 1 ile 64 yýl arasýnda deðiþmekteydi. Gruplar arasýnda WBC (p=0.002), nötrofil (p=0.002), lenfosit (p=0.032), trombosit (p=0.032), RDW (p=0.001), CRP (p=0.009), PNR (p=0.042), WNR (p=0.03) ve apendiks uzunluðu (p<0.001) açýsýndan istatistiksel olarak anlamlý farklýlýklar saptandý. Negatif apendektomi oraný transplant grubunda nisbeten daha yüksek olmakla birlikte bu farklýlýk istatistiksel olarak anlamlý deðildi (%30.8 ve %21.2; p=0.477). Perfore apandisit transplant grubunda çok daha sýk görülmekle birlikte bu farklýlýk istatistiksel olarak anlamlý deðildi (%30.8 ve %9.6; p=0.070).
TARTIÞMA: WBC ve nötrofil LT grubunda daha düþüktü; CRP ve RDW LT grubunda daha yüksekti. Perforasyon ve negatif apendektomi oranlarý LT grubunda daha yüksekti, ancak bu fark istatistiksel olarak anlamlý bulunmamýþtýr.