Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

IBD after liver transplantation for primary sclerosing cholangitis

This month's issue of the American Journal of Gastroenterology investigates the course of inflammatory bowel disease after liver transplantation for primary sclerosing cholangitis.

News image

Inflammatory bowel disease (IBD) after liver transplantation for primary sclerosing cholangitis (PSC) is complex, with several IBD-, primary sclerosing cholangitis-, and transplant-related factors interplaying with each other.

Dr Jayant Talwalkar and colleagues from Minnesota, USA reviewed the course of IBD after liver transplantation in these patients.

The team report that approximately one-third of patients with known IBD improve, and one-third paradoxically worsen, after liver transplantation for primary sclerosing cholangitis.

Active IBD, discontinuation of 5-aminosalicylates (5-ASA) at time of liver transplantation and tacrolimus-based immunosuppression may be associated with an unfavorable course of IBD after liver transplantation.

The team found that about 14–30% patients with primary sclerosing cholangitis may develop de novo IBD 10 years after liver transplantation.

Liver transplantation confers a high risk of pouchitis after ileal pouch-anal anastomosis, although it may not be higher than baseline rates for primary sclerosing cholangitis patients.

The team noted that the risk of colorectal cancer continues to be high after liver transplantation for primary sclerosing cholangitis, and is higher in this cohort of patients with primary sclerosing cholangitis-IBD, compared with patients undergoing liver transplantation for other indications.

IBD does not adversely affect patient survival after liver transplantation, although the risk of recurrent primary sclerosing cholangitis in the allograft may be higher in patients with IBD and an intact colon at time of liver transplantation.

The researchers report that standard therapy with 5-ASA and/or azathioprine may be appropriate for treatment of active IBD after liver transplantation and maintenance of remission.

Dr Talwalkar's team concludes, "Anti-tumor necrosis factor-α agents are effective, but should be used with caution because of high risk of adverse events."

"The management of IBD after liver transplantation requires close coordination between transplant hepatologists and IBD experts."

Am J Gastroenterol 2013; 108: 1417–1425
26 September 2013

Go to top of page Email this page Email this page to a colleague

 23 November 2014

Advanced search
 21 November 2014 
Skin cancer in ulcerative colitis patients
 21 November 2014 
Mortality of chemoembolization in hepatocellular carcinoma
 21 November 2014 
Hepatic involvement in IgG4-related disease
 20 November 2014 
Global measures in chronic idiopathic constipation
 20 November 2014 
Macrophage activation in alcoholic hepatitis
 20 November 2014 
Covert hepatic encephalopathy and survival
 19 November 2014 
Thiopurine withdrawal in IBD
 19 November 2014 
Esophageal narrowing in esophageal eosinophilia
 19 November 2014 
Second intestinal resection in Crohn's
 18 November 2014 
Colorectal neoplasia and vitamin D
 18 November 2014 
Food-associated changes in the intestinal mucosa in IBS
 18 November 2014 
Alternative medicine use by US adults
 17 November 2014 
Treatment of obesity in primary care settings
 17 November 2014 
Allergy-related diseases and abdominal pain in childhood
 17 November 2014 
Diagnosis of monogenic very early onset IBD
 14 November 2014 
Second intestinal resection in Crohn's
 14 November 2014 
HCC risk in active stage Hep B
 14 November 2014 
Thiopurine and clinical remission in IBD
 13 November 2014 
Antibiotics and risk of new-onset Crohn’s
 13 November 2014 
Chronic Hep C genotype 1 treatment after relapse
 13 November 2014 
Chemoembolization for hepatocellular carcinoma
 12 November 2014 
Risk of hepatocellular carcinoma
 12 November 2014 
Abdominal symptom severity in chronic idiopathic constipation
 12 November 2014 
Screening colonoscopy
 11 November 2014 
Hepatocellular carcinoma in Hep B with nucleotide analogue
 11 November 2014 
Familial colorectal cancer screening
 11 November 2014 
Fecal microbiota transplant for C. diff
 10 November 2014 
STaples IPAA for ulcerative colitis
 10 November 2014 
Blood stream infections in acute liver failure
 10 November 2014 
Ig4-related disease
 07 November 2014 
Host and viral factors in chronic Hep C
 07 November 2014 
Celiac diagnosis without biopsy
 07 November 2014 
Pricing practices of gastroenterologists
 06 November 2014 

Colorectal surgery postdischarge occurrences and readmissions

 06 November 2014 
Thromboprophylaxis in IBD
 06 November 2014 
Steatosis biomarkers in NAFLD
 05 November 2014 
Readmission risk factors for patients with IBD
 05 November 2014 
Hysterectomy and colonoscopy completion
 05 November 2014 
Adalimumab in Crohn's disease
 04 November 2014 
Gut barrier dysfunction and CNS disorders
 04 November 2014 
Hemospray for nonvariceal upper GI bleeding
 04 November 2014 
Sleep duration and ulcerative colitis
 03 November 2014 
Mucosal pathophysiology in HIV and IBD
 03 November 2014 
Managing bleeding gastroduodenal ulcers
 03 November 2014 
Identifying inflammation in ulcerative colitis
 31 October 2014 
Pregnancy complications in celiac disease
 31 October 2014 
Pediatric NAFLD
 31 October 2014 
C. difficile infection with metronidazole
 30 October 2014 
Cirrhosis in women
 30 October 2014 
Costs in newly diagnosed patients with chronic constipation
 30 October 2014 
Constipation and colorectal cancer
 29 October 2014 
Quality of life after infection with E. coli
 29 October 2014 
IBS in primary care
 29 October 2014 
Sensorimotor activity in functional dyspepsia
 28 October 2014 
Increased bile acid synthesis in IBS-diarrhea
 28 October 2014 
Successful radiofrequency ablation for Barrett’s
 28 October 2014 
Risk factor for smaller final height in Crohn's
 27 October 2014 
Celiac disease and type 1 diabetes
 27 October 2014 
Gluten awareness among chefs
 27 October 2014 

PPI-responsive esophageal eosinophilia

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us