Inflammatory bowel disease (IBD) is associated with primary sclerosing cholangitis (PSC) and autoimmune hepatitis.
IBD can recur or develop de novo after orthotopic liver transplantation.
In this study, scientists from the United States investigated the incidence and severity of IBD after liver transplantation. They also used multivariate techniques to identify possible risk factors.
The team performed a retrospective study, which included 91 patients transplanted for PSC (n = 60) or autoimmune hepatitis (n = 31), without prior colectomy.
Overall, 54% of patients had IBD before orthotopic liver transplantation.
|5-aminosalicylates protect against recurrence.|
|American Journal of Transplantation|
The scientists determined that 44% of patients had active IBD after transplantation; recurrence in 32 and de novo in 8.
They found that the cumulative risk for IBD after liver transplantation was 15, 39 and 54% after 1, 5 and 10 years, respectively.
Furthermore, in 59% of patients with IBD prior to orthotopic liver transplantation, the disease was more active after transplantation.
Dr Verdonk's team concluded, "Risk factors for recurrent disease were: symptoms at time…transplantation, short interval of IBD before…transplantation, and use of tacrolimus".
"A cytomegalovirus positive donor/negative recipient combination increased the risk for de novo IBD".