ORLANDO, Fla. — Liver transplant recipients with IBD are more likely to experience worsening disease post-transplant with shorter disease duration, according to data presented at Digestive Disease Week.
Researchers performed a retrospective chart analysis of 924 patients who underwent liver transplantation (LT) between 1998 and 2012. The cohort included 45 patients with post-transplant IBD, including 38 with previous IBD and seven who developed de novo IBD after the procedure. IBD severity was determined according to symptoms, complications, hospitalizations because of flares and use of steroids or immunosuppressive medications.
Among patients with prior IBD, 39% experienced a worsening of their condition after the procedure, 11% improved and the remaining 50% had inactive IBD. Twenty-two participants, including all seven who developed post-transplant IBD, had active disease after LT.
A shorter duration of IBD before transplantation was significantly associated with a risk for worsening disease post-transplant (P=3.261E-07), particularly among those with prior IBD for 8 years or fewer. No association was observed between the risk for increased IBD severity and gender (P=.7763) ethnicity (P=.5813), smoking (P=.6614) or cytomegalovirus infection (P=.2825). The researchers said primary sclerosing cholangitis existed in the majority of patients with active post-LT IBD, but could not determine its status as a risk factor for worsening IBD because it was the major indication for LT in the study population.
“We found that 8 years or less of IBD duration at time of liver transplant might be a potential risk factor,” researcher Maiyen Tran Hawkins, DO, a fellow at Georgetown University Hospital in Washington, told Healio.com. “In knowing that potential risk factor, more aggressive medical management might be needed for those patients who have a shorter duration of IBD prior to the liver transplant, to potentially prevent or reduce their risk of worsening disease.”
Disclosure: Researchers Kirti Shetty, MD,and Aline Charabaty, MD, reported numerous financial disclosures.
For more information:
Hawkins MT. Mo1280: Inflammatory Bowel Disease Activity Following Liver Transplantation: Potential Risk Factors for De Novo Disease and for Increase in Disease Severity. Presented at: Digestive Disease Week 2013; May 18-21, Orlando, Fla.