The course of ulcerative colitis following orthotopic liver transplantation for primary sclerosing cholangitis is unclear.
Dr Ho and colleagues documented the nationwide experience of the course of ulcerative colitis.
A total of 470 liver transplants were performed for 413 patients between 1992 and 2003, in the Scottish Liver Transplantation Unit.
The investigative team reported that 26 patients had co-existing ulcerative colitis or primary sclerosing cholangitis.
Of these, data from 20 patients were studied over a median period of 12 years before orthotopic liver transplantation.
|35% of patients underwent colectomy after orthotopic liver transplantation|
|European Journal of Gastroenterology & Hepatology|
The investigators also assessed the data 4 years after orthotopic liver transplantation.
The team noted that 4 patients required colectomy prior to orthotopic liver transplantation.
The investigators found that 1 died within 7 days of transplant, and 1 developed ulcerative colitis after transplant.
A significantly higher relapse rate was seen after orthotopic liver transplantation.
The team found that corticosteroids requirement after orthotopic liver transplantation was also significantly higher.
In addition, the investigators observed that 20% of patients became corticosteroid dependent after orthotopic liver transplantation.
The team noted that 35% of patients underwent colectomy after orthotopic liver transplantation, of which 3 had severe disease and 4 had neoplasia/dysplasia.
A further 5 patients developed neoplasia following orthotopic liver transplantation.
Dr Ho's team commented, “Despite immunosuppression, ulcerative colitis follows a more aggressive clinical course after orthotopic liver transplantation and is associated with a high rate of neoplasia.”