Upper and lower gastrointestinal diseases in liver transplant candidates

Abstract

Background: The incidence and risk factors of gastrointestinal diseases in pre-liver transplant population are still a matter of debate. In a retrospective analysis, we addressed two questions: (1) Are there any lesions that occur at a higher prevalence than in the general population, and (2) are there patient characteristics that could predict their presence?

Materials and methods: All asymptomatic patients that successfully entered the waiting list of liver transplantation were recorded. We also compared results with those obtained from a control group of non-cirrhotic patients undergoing screening for colorectal cancer. Main outcome measures were the incidence and description of upper/lower gastrointestinal findings after screening endoscopic examination.

Results: We retrospectively evaluated from April 2004 to July 2007 a total of 80 liver transplant candidates. The most frequent pathologies were esophageal varices (71.2% of subjects), portal hypertensive gastropathy (51.2%), hemorrhoids (22.5%), and colonic polyps (18.7%). Comparison with 80 non-cirrhotic patients matched for age and sex demonstrated an increased frequency in the cirrhotic group of ulcerative colitis (6.2 vs 0%; p = 0.02) and portal hypertensive colopathy (12.5 vs 0%; p = 0.001) in non-cirrhotic of diverticulosis (10 vs 25%; p = 0.01) and hemorrhoids (22.5 vs 40%; p = 0.02). The univariate analysis showed no significant correlation between colonic polyps and patients' variables, except a mild correlation with age not confirmed at the multivariate analysis.

Conclusions: The incidence of some benign gastrointestinal pathologies in liver transplant candidates is different from the asymptomatic population but not that of colorectal cancer or colonic polyps.