Diverticulosis is a common finding in Autosomal Dominant Polycystic Kidney Disease (ADPKD). To avoid the serious complications of diverticulosis after kidney transplantation, some policies have recommended aggressive actions, such as elective colectomy, in these patients. These policies are not widely agreed upon. This made us to investigate the serious complications and the outcome of diverticulosis in ADPKD kidney recipients to see whether these therapies are justified or not. From 2002 to 2006, we followed 18 kidney recipient ADPKD patients with barium enema approved diverticulosis in Baqiyatallah hospital, Tehran, Iran. All subjects were asymptomatic for diverticulosis at the time of transplantation. The mean ± SD of follow up duration was 17.78 ± 10.53 months. Demographic data, Familial history of ADPKD, findings of Barium enema and complications as well as graft and patient survival were registered. Hepatic flexure was the most prevalent site for diverticula. The mean (SD) of diverticules count was 6.06±5.14. Patients with familial history of ADPKD, had a higher number of diverticules (p=0.01). Colon perforation occurred in 3 patients (16.7%) which all of them led to death.
Conclusion: Perforation of colon is a fatal but not a rare complication in ADPKD patients. The rate of complications in our study is similar to previous finings, but we observed the serious complications even in asymptomatic patients at the time of transplantation. The decision about taking an aggressive action like elective colectomy remains to be a matter of debate and needs further evaluation.