Crohn's Disease Recurrence in a Small Bowel Transplant

Kaila, Brinderjit; Grant, David; Pettigrew, Norman M.; Greenberg, Howard E.; Bernstein, Çharles N.

doi:10.1046/j.1572-0241.2003.04004.x

Cited by 22 publications

(6 citation statements)

References 16 publications

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“…There are occasional case descriptions, e.g. on a late‐onset manifestation of Crohn’s disease recurrence 8 years after ITx which responded to steroids [65]. However, systematic studies to determine the frequency, predictors, and clinical implications of recurrent Crohn’s disease have not been reported.…”

Section: Outcome and Complicationsmentioning

confidence: 99%

Present status and future perspectives of intestinal transplantation

Pascher¹,

Köhler²,

Neuhaus³

et al. 2008

Transplant Int

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Summary Intestinal transplantation (ITx) is the only definitive therapy for irreversible intestinal failure. Owing to the limited short‐ and long‐term graft survival over the years, ITx has been a complementary treatment to home parenteral nutrition. However, the development of intestinal and multivisceral transplantation has been significant over the past 15–20 years owing to the progress in immunosuppressive therapy, refinement of surgical techniques, post‐transplant care, intestinal immunology, and immunological as well as anti‐infectious monitoring. The improvement of patient‐ and graft survival over the last few years together with data on the cost effectiveness of ITx, following 2 years after transplantation, may require a redefinition of the indication for ITx.

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Section: Outcome and Complicationsmentioning

confidence: 99%

Present status and future perspectives of intestinal transplantation

Pascher¹,

Köhler²,

Neuhaus³

et al. 2008

Transplant Int

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“…140 Seven years later, a second case report was published from London, Ontario with successful outcome after steroid and azathioprine therapy. 141 In 2005, a small series of 6 CD patients were longitudinally followed after small bowel transplantation with serial random endoscopic-guided biopsies. 142 With 2 early postoperative deaths, 2 of the 4 surviving recipients showed intermittent documentation of non-necrotizing epithelioid cell granulomas that was limited to the lamina propria, and no special treatment was initiated.…”

Section: Disease Recurrencementioning

confidence: 99%

Management of Crohnʼs Disease in the New Era of Gut Rehabilitation and Intestinal Transplantation

Nyabanga

Kochhar

Costa

et al. 2016

Inflammatory Bowel Diseases

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Despite recent therapeutic advances, patients with Crohn's disease (CD) continue to experience high recurrence with cumulative structural damage and ultimate loss of nutritional autonomy. With short bowel syndrome, strictures, and enteric fistulae being the underlying pathology, CD is the second common indication for home parenteral nutrition (HPN). With development of intestinal failure, nutritional management including HPN is required as a rescue therapy. Unfortunately, some patients do not escape the HPN-associated complications. Therefore, the concept of gut rehabilitation has evolved as part of the algorithmic management of these patients, with transplantation being the ultimate life-saving therapy. With type 2 intestinal failure, comprehensive rehabilitative measures including nutritional care, pharmacologic manipulation, autologous reconstruction, and bowel lengthening is often successful, particularly in patients with quiescent disease. With type 3 intestinal failure, transplantation is the only life-saving treatment for patients with HPN failure and intractable disease. With CD being the second common indication for transplantation in adults, survival outcome continues to improve because of surgical innovation, novel immunosuppression, and better postoperative care. Despite being a rescue therapy, the procedure has achieved survival rates similar to other solid organs, and comparable to those who continue to receive HPN therapy. With similar technical, immunologic, and infectious complications, survival is similar in the CD and non-CD recipients. Full nutritional autonomy is achievable in most survivors with better quality of life and long-term cost-effectiveness. CD recurrence is rare with no impact on graft function. Further progress is anticipated with new insights into the pathogenesis of CD and mechanisms of transplant tolerance.

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“…If intestinal failure occurs, home parenteral nutrition and intes tinal transplantation can be discussed [72]. Interestingly, several cases of CD recurrence after intestinal transplantation have been reported [73][74][75], which may indicate that the immune system plays a more important role than the mucosal barrier in the pathogenesis of CD.…”

Section: Other Treatmentsmentioning

confidence: 99%

The role of mesenchymal stromal cells in the treatment of ulcerative colitis andCrohn's disease

Gregoire

Lechanteur

Briquet

et al. 2016

The Biology and Therapeutic Application of Mesenchymal Cells

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Differentiation and stimulation of tissue repair, 740 50.6 Mesenchymal stromal cell administration in inflammatory bowel diseases, 740 50.6.1 Mesenchymal stromal cell administration for fistulizing Crohn's disease, 741 50.6.2 Autologous mesenchymal stromal cell administration for fistulizing Crohn's disease, 741 50.1 Inflammatory bowel diseases Inflammatory bowel diseases (IBDs) are chronic relapsing dis eases associated with debilitating symptoms and leading to progressive intestinal tissue damage and disability (Figure 50.1). Crohn's disease (CD) can affect any part of the gastrointestinal tract, and lesions are often segmental and transmural. The disease was named after gastroenterologist Dr Burrill Bernard

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Crohn's Disease Recurrence in a Small Bowel Transplant

Cited by 22 publications

References 16 publications

Present status and future perspectives of intestinal transplantation

Present status and future perspectives of intestinal transplantation

Management of Crohnʼs Disease in the New Era of Gut Rehabilitation and Intestinal Transplantation

The role of mesenchymal stromal cells in the treatment of ulcerative colitis andCrohn's disease

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