Risk of colonic neoplasia after liver transplantation for primary sclerosing cholangitis
Article first published online: 18 MAR 2011
Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.
Inflammatory Bowel Diseases
Volume 18, Issue 2, pages 269–274, February 2012
How to Cite
Hanouneh, I. A., Macaron, C., Lopez, R., Zein, N. N. and Lashner, B. A. (2012), Risk of colonic neoplasia after liver transplantation for primary sclerosing cholangitis. Inflamm Bowel Dis, 18: 269–274. doi: 10.1002/ibd.21692
- Issue published online: 10 JAN 2012
- Article first published online: 18 MAR 2011
- Manuscript Accepted: 25 JAN 2011
- Manuscript Received: 14 JAN 2011
- primary sclerosing cholangitis;
- colonic neoplasia;
- liver transplantation
Primary sclerosing cholangitis (PSC) confers an increased risk of colon cancer in patients with inflammatory bowel disease (IBD). However, there is a scarcity of data to determine whether the rate of colon cancer changes after liver transplantation (LT) in IBD patients with PSC. The aims were 1) to estimate the risk of colon neoplasia after LT in IBD patients with PSC; 2) to identify the factors associated with colon neoplasia after LT in IBD patients with PSC.
We identified patients with IBD/PSC who underwent LT from 1998–2005 (n = 43). Two control groups were identified. Control 1 was IBD/PSC who did not undergo LT, matched 1:1 for age, gender, and type of IBD. Control 2 was patients with chronic liver disease other than PSC who underwent LT, matched 1:1 for age, gender, and follow-up time since LT. All patients were monitored by serial colonoscopy. Logistic regression analysis was used.
During a mean follow-up of 54.7 ± 47.7 months, patients with IBD/PSC who underwent LT had similar rate of colon neoplasia compared to those who did not have LT (34% versus 30%, P = 0.24). The rate of colon neoplasia in LT recipients was higher in PSC patients compared to those with other forms of chronic liver disease (34% versus 0%, P = 0.018). Post-LT cytomegalovirus infection was associated with higher likelihood of colon neoplasia post-LT in IBD/PSC patients (hazard ratio = 4.4, P = 0.024). There was no significant difference in survival outcome between the three study groups.
IBD/PSC patients remain at an increased risk of colon neoplasia after LT. (Inflamm Bowel Dis 2011;)