Inflammatory Bowel Disease After Liver Transplantation: Risk Factors for Recurrence and De Novo Disease

Verdonk, Robert C.; Dijkstra, Gerard; Haagsma, Elizabeth B.; Shostrom, Valerie; Berg, Aad P. van den; Kleibeuker, Jan H.; Langnas, Alan Norman; Sudan, Debra

doi:10.1111/j.1600-6143.2006.01333.x

Cited by 155 publications

(136 citation statements)

References 47 publications

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“…Presence of a positive CMV donor with a negative recipient [189,190] and use of Tacrolimus post-liver transplant [191] has been identified as risk factors for the development of de novo IBD. It is believed that CMV and Tacrolimus can affect the mucosal immune system (via altering the epithelial barrier system [189] or reducing the interleukin-2 dependent generation of regulatory T cells [192,193] respectively) increasing IBD activity. The diagnosis and management is often challenging.…”

Section: Ibd and Liver Transplantationmentioning

confidence: 99%

“…Conflicting reports of IBD activity have been published regarding the impact of a liver transplant on patients with preexisting IBD [192][193][194][195][196]. Risk factors for worsening of preexisting IBD after liver transplant includes active bowel inflammation at the time of transplantation [193], short interval between diagnosis of IBD and transplant [193], cigarette smoking [197], Clostridium difficile infection [198] and use of Tacrolimus after transplant [191,193,199,200].…”

Section: Ibd and Liver Transplantationmentioning

confidence: 99%

“…Risk factors for worsening of preexisting IBD after liver transplant includes active bowel inflammation at the time of transplantation [193], short interval between diagnosis of IBD and transplant [193], cigarette smoking [197], Clostridium difficile infection [198] and use of Tacrolimus after transplant [191,193,199,200]. The use of steroid or immunosuppressive agents prior to transplant does not predict post-transplant IBD activity [194,195].…”

Section: Ibd and Liver Transplantationmentioning

confidence: 99%

“…The use of steroid or immunosuppressive agents prior to transplant does not predict post-transplant IBD activity [194,195]. Steroids, Azathioprine and Cyclosporine should be preferred in these subgroup of patients [94,193,[199][200][201]. The therapeutic response and outcome is usually poor when compared to the de novo IBD patients; requiring colectomy for refractory bowel disease [197,199,200].…”

Section: Ibd and Liver Transplantationmentioning

confidence: 99%

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A review of liver disorders in inflammatory bowel disease (IBD)

Shah¹,

Gupta²,

Borg³

2017

Clin Case Rep Rev

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Disorders of the liver and the biliary tract are frequently the extraintestinal manifestations of inflammatory bowel disease (IBD). The etiology of these hepato-biliary conditions is deemed secondary to their shared pathogenesis, the chronic effects of a long term, ongoing inflammation of the bowels, along with the medications used to manage IBD. For up to 30% of patients with IBD, abnormal liver biochemical tests are present. Other, selected patients with IBD are followed for reactivation of hepatitis B, through guidelines only relatively recently in place. The vast realm of related clinical conditions does not always correspond well with IBD severity, which can range from mild hepatic insult to end-stage liver disease, necessitating liver transplantation. Hence it is critical to follow its presence, clinical course and long term consequences. Moreover, the management of these disorders is necessarily individualized, with some patients requiring frequent monitoring and others a more multi-disciplinary approach. Studies aimed at improving the outcomes of patients with IBD who experience associated liver and biliary tract disorders are now needed to assess early identification, possible screening approaches and more effective systems of referral. This article covers the evidence-based literature on topics detailing the co-existence of liver conditions in inflammatory bowel disease with a focus on its epidemiology, clinical manifestations, diagnosis and management.

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Section: Ibd and Liver Transplantationmentioning

confidence: 99%

Section: Ibd and Liver Transplantationmentioning

confidence: 99%

Section: Ibd and Liver Transplantationmentioning

confidence: 99%

Section: Ibd and Liver Transplantationmentioning

confidence: 99%

See 2 more Smart Citations

A review of liver disorders in inflammatory bowel disease (IBD)

Shah¹,

Gupta²,

Borg³

2017

Clin Case Rep Rev

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“…9 Risk factors for recurrent primary sclerosing cholangitis after orthotopic liver transplant include sex mismatch, 10 male sex, 11 steroid-resistant acute cellular rejection, 5,12 and inflammatory bowel disease. After orthotopic liver transplant, up to 60% patients have progressive inflammatory bowel disease 13 and some patients develop de novo ulcerative colitis. Severe or de novo ulcerative colitis after orthotopic liver transplant is a risk factor for recurrent primary sclerosing cholangitis, and colectomy before orthotopic liver transplant may be protective against recurrent primary sclerosing cholangitis.…”

Section: Introductionmentioning

confidence: 99%

Survival Without Biliary Complications After Liver Transplant for Primary Sclerosing Cholangitis

Mogl

Albert²,

Pascher³

et al. 2013

Exp Clin Transplant

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Objectives: Patients who have a liver transplant for primary sclerosing cholangitis may develop recurrent disease and biliary complications, organ loss necessitating revision liver transplant, or death. We evaluated long-term outcomes in patients who had liver transplant for primary sclerosing cholangitis. Materials and Methods: In 71 patients who had a liver transplant for end-stage liver disease because of primary sclerosing cholangitis, a retrospective review was done to evaluate biliary complicationfree survival, transplanted organ survival, and death. Human leukocyte antigen typing and matching were reviewed. Results: There were 39 patients (55%) who had biliary complications, loss of the liver transplant, or death at a mean 12.1 years after transplant. The 5-and 10-year event-free survival reached 74.6% and 45% (53 patients after 5 years, and 32 patients after 10 years). Male sex of transplant recipients was a significant risk factor for biliary complications, revision liver transplant, or death. Most patients had inflammatory bowel disease, primarily ulcerative colitis. The human leukocyte antigen profile or number of mismatches had no effect on complication-free survival. Conclusions: Biliary complications, revision liver transplant, and death are a useful combined primary endpoint for recurrent primary sclerosing cholangitis after liver transplant.

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Colonoscopic Screening and Surveillance in the Patient with Liver Disease (Including Post‐Transplant)

Tierney

Chaudrey

2017

Endoscopy in Liver Disease

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Inflammatory Bowel Disease After Liver Transplantation: Risk Factors for Recurrence and De Novo Disease

Cited by 155 publications

References 47 publications

A review of liver disorders in inflammatory bowel disease (IBD)

A review of liver disorders in inflammatory bowel disease (IBD)

Survival Without Biliary Complications After Liver Transplant for Primary Sclerosing Cholangitis

Colonoscopic Screening and Surveillance in the Patient with Liver Disease (Including Post‐Transplant)

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