PSC transplant recipients with IBD may have increased risk for dysplasia

ORLANDO — Patients with inflammatory bowel disease who undergo liver transplantation for primary sclerosing cholangitis may have an increased risk for developing colonic dysplasia pre- and post-transplantation, according to a poster presented at the 2016 Advances in IBD Meeting.

Ravish Parekh, MD, third-year fellow, Henry Ford Hospital, Michigan, and colleagues retrospectively reviewed records of 48 patients with IBD who underwent LT for PSC at Henry Ford Health System between 1993 and 2015, to measure all pre- and post-LT outcomes. The patients underwent annual colonoscopies before and after transplant, per standard of care, and researchers collected data on dysplasia or neoplasia viewed on biopsies.

“Primary sclerosing cholangitis has been associated with increased incidence of colorectal dysplasia and neoplasia in patients with inflammatory bowel disease compared to the patients with [inflammatory bowel disease] without [primary sclerosing cholangitis],” the researchers wrote. “We aimed to assess the incidence of dysplasia in patients with PSC-IBD who underwent liver transplantation for PSC.”

Thirty-two males and 16 females with underlying IBD underwent LT for PSC. Of these, 83% had ulcerative colitis (UC; n = 40), four had Crohn’s disease (CD) and two had indeterminate colitis.

Analysis showed that six patients had dysplasia of colon, of which two were diagnosed with post-LT. Four of the six patients underwent colectomy and two were followed through serial colon biopsies. In addition, four of six patients had uncontrolled active IBD when diagnosed with colonic dysplasia. The mean duration of diagnosis of IBD to dysplasia was 31.1+ 13.4 years, according to the research.

The researchers did not observe any significant difference in the occurrence of dysplasia pre-LT compared with post-LT.

They concluded: “PSC in patients with IBD carries an increased risk of colonic dysplasia both before and after LT. … Annual surveillance colonoscopy should be used for early detection of dysplasia.”

Reference:

Parekh R, et al. Abstract P-163. Presented at: Advances in Inflammatory Bowel Diseases; Dec. 8-10, 2016; Orlando, Fla.

Disclosures: Healio Gastroenterology was unable to confirm relevant financial disclosures at the time of publication.