Inflammatory bowel disease in liver transplanted patients
نویسندگان
چکیده
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.
منابع مشابه
Lack of Association between Interleukin 23R (IL-23R) rs10889677 Polymorphism and Inflammatory Bowel Disease Susceptibility In an Iranian Population
Background: Inflammatory bowel diseases (IBDs), which include ulcerative colitis (UC) and Crohn’s disease (CD), are inflammatory disorders that affect the gastrointestinal tract. A combination of inflammatory cytokines has an important role in IBD development. Genome-wide association studies have shown that polymorphisms in the interleukin-23R gene (IL-23R) increase susceptibility to IBD....
متن کاملApplication of extracellular vesicles in the treatment of inflammatory bowel disease
Introduction: Inflammatory bowel disease(IBD) is caused by genetic, environmental, microbial and immune factors. IBD has two primary forms: Ulcerative colitis and Crohn´s disease. The incidence of IBD has significantly increased over the last few decades. Given that patients have poor response to drug treatments or are resistant to drug therapies, new therapies are needed for gastrointestinal i...
متن کاملThe Study of Upper Gastrointestinal Endoscopy in Patients with Inflammatory Bowel Disease and Ulcerative Colitis
Background and aims: In diagnosing inflammatory bowel disease, one of diagnostic way is upper gastrointestinal endoscopy, which helps in differential diagnosis of unspecified colitis as well. The aim of this study was to investigate the necessity of upper gastrointestinal endoscopy in patients with inflammatory bowel disease. Materials and Methods: In this descriptive cross-sectional...
متن کاملEvaluation of Bcl2/BAX genes expression ratio as a marker of inflammatory bowel disease
Background: Apoptosis is an essential physiological process to maintain immune homeostasis. T-cell incorrect apoptosis appears to be involved in chronic inflammatory diseases such as inflammatory bowel disease (IBD). The aim of this study was to evaluate the Bcl2/BAX genes expression ratio in patients with IBD (Crohn’s disease and ulcerative colitis) compared to healthy persons. Materials and M...
متن کاملInflammatory Bowel Disease in Primary Sclerosing Cholangitis: Clinical Characteristics in Liver Transplanted and Non-Transplanted Patients
متن کامل
Ulcerative colitis has an aggressive course after orthotopic liver transplantation for primary sclerosing cholangitis.
BACKGROUND The course of inflammatory bowel disease after liver transplantation has been reported as variable with usually no change or improvement, but there may be an increased risk of early colorectal neoplasms. In many centres steroids are often withdrawn early after transplantation and this may affect inflammatory bowel disease activity. AIMS To evaluate the course of inflammatory bowel ...
متن کامل