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Review
. 2017 May 14;23(18):3214-3227.
doi: 10.3748/wjg.v23.i18.3214.

Inflammatory bowel disease in liver transplanted patients

Affiliations
Review

Inflammatory bowel disease in liver transplanted patients

Tajana Filipec Kanizaj et al. World J Gastroenterol. .

Abstract

Most common hepatobiliary manifestation of inflammatory bowel disease (IBD) are primary sclerosing cholangitis (PSC) and autoimmune hepatitis, ranking them as the main cause of liver transplantation (LT) in IBD setting. Course of pre-existing IBD after LT differs depending on many transplant related factors. Potential risk factors related to IBD deterioration after LT are tacrolimus-based immunosuppressive regimens, active IBD and cessation of 5-aminosalicylates at the time of LT. About 30% patients experience improvement of IBD after LT, while approximately the same percentage of patients worsens. Occurrence of de novo IBD may develop in 14%-30% of patients with PSC. Recommended IBD therapy after LT is equivalent to recommendations to overall IBD patients. Anti-tumor necrosis factor alpha appears to be efficient for refractory IBD. Due to potential side effects it needs to be applied with caution. In average 9% of patients require proctocolectomy due to medically refractory IBD or colorectal carcinoma. The most frequent complication in patients who undergo proctocolectomy with ileal-pouch anal anastomosis is pouchitis. It is still undeterminable if LT adds to risk of developing pouchitis in PSC patients. Annual colonoscopies are recommended as surveillance and precaution of colonic malignancies.

Keywords: Anti-TNF alpha therapy; Immunomodulatory therapy; Immunosuppression; Inflammatory bowel disease; Liver transplantation; Proctoproctocolectomy; Risk factors.

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Conflict of interest statement

Conflict-of-interest statement: All authors who have taken part in this study declared that they have nothing to disclose regarding funding or conflict of interest with respect to this manuscript.

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References

    1. Podolsky DK. Inflammatory bowel disease. N Eng J Med. 2002;347:417–429. - PubMed
    1. Chapman RW, Arborgh BA, Rhodes JM, Summerfield JA, Dick R, Scheuer PJ, Sherlock S. Primary sclerosing cholangitis: a review of its clinical features, cholangiography, and hepatic histology. Gut. 1980;21:870–877. - PMC - PubMed
    1. Eaton JE, Talwalkar JA, Lazaridis KN, Gores GJ, Lindor KD. Pathogenesis of primary sclerosing cholangitis and advances in diagnosis and management. Gastroenterology. 2013;145:521–536. - PMC - PubMed
    1. Fausa O, Schrumpf E, Elgjo K. Relationship of inflammatory bowel disease and primary sclerosing cholangitis. Semin Liver Dis. 1991;11:31–39. - PubMed
    1. Chapman R, Fevery J, Kalloo A, Nagorney DM, Boberg KM, Shneider B, Gores GJ. Diagnosis and management of primary sclerosing cholangitis. Hepatology. 2010;51:660–678. - PubMed

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