The Effect of Liver Transplantation for Primary Sclerosing Cholangitis on Disease Activity in Patients with Inflammatory Bowel Disease.
Immunosuppressive therapies are indicated following liver transplantation (LT) to prevent graft loss through rejection, and these same agents also may have a role in the management of inflammatory bowel disease (IBD). The aims of this study were to examine the effects of immunosuppression following...
| Publicado en: | Gastroenterology & Hepatology Vol. 9; no. 7; pp. 434 - 442 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Gastro-Hep Communications, Inc
Jul2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=97677157&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 97677157 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15547914 6N5B jtl: Gastroenterology & Hepatology issn: 15547914 maglogo: N pubinfo: dt: Jul2013 vid: 9 iid: 7 pid: 72163 pub: Gastro-Hep Communications, Inc place: New York, New York artinfo: ui: 97677157 97677157 103993622 97677157 ppf: 434 ppct: 8 formats: fmt: @attributes: type: P tig: atl: The Effect of Liver Transplantation for Primary Sclerosing Cholangitis on Disease Activity in Patients with Inflammatory Bowel Disease. aug: au: Mosli, Mahmoud Croome, Kristopher Qumosani, Karim Al-judaibi, Bandar Beaton, Melanie Marotta, Paul Chandok, Natasha affil: Department of Medicine, Multi-Organ Transplant Unit, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada sug: subj: Liver Transplantation Evaluation Cholangitis, Sclerosing Physiopathology Inflammatory Bowel Diseases Diagnosis Human Immunosuppressive Agents Time Factors Retrospective Design Unpaired T-Tests Chi Square Test Univariate Statistics Logistic Regression ab: Immunosuppressive therapies are indicated following liver transplantation (LT) to prevent graft loss through rejection, and these same agents also may have a role in the management of inflammatory bowel disease (IBD). The aims of this study were to examine the effects of immunosuppression following LT on IBD activity and to identify markers of IBD control post-LT in patients with IBD who underwent LT for primary sclerosing cholangitis (PSC). A retrospective analysis of all adult patients with a pre-LT diagnosis of IBD who underwent LT for PSC over a 15-year period was performed. The primary outcome was IBD activity based on symptomatology and endoscopic assessment. Secondary outcomes included recipient mortality and post-LT development of colorectal cancer or small bowel lymphoma. A total of 105 patients underwent LT for PSC, and IBD was diagnosed in 27 (26%) pre-LT. Patients were followed for a mean of 88.5 months. Fourteen (52%) patients had stable IBD, 6 (22%) had worsening disease, and 7 (26%) had clinical improvement after LT. Colorectal cancer developed in 2 (7%) patients, and small bowel lymphoma developed in 1 (4%) patient. The absence of additional maintenance therapy for IBD was found to be associated with good outcome for IBD control. The use of either infliximab (Remicade, Janssen Biotech) or corticosteroids to control IBD post-LT was associated with poor outcome. Most patients with PSC and IBD had a stable course of IBD post-LT. The need for infliximab or additional or prolonged corticosteroids after LT appears to be a surrogate marker of aggressive disease. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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