Inflammatory bowel disease course in liver transplant versus non-liver transplant patients for primary sclerosing cholangitis: LIVIBD, an IG-IBD study.


Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385

Informations de publication

Date de publication:
06 2021
Historique:
received: 24 06 2020
revised: 15 09 2020
accepted: 15 09 2020
pubmed: 26 9 2020
medline: 1 2 2022
entrez: 25 9 2020
Statut: ppublish

Résumé

Data regarding the effect of orthotopic liver transplantation (OLT) for primary sclerosing cholangitis (PSC) on inflammatory bowel disease (IBD) course are scarce and conflicting. To compare the incidence of refractory IBD in two groups (OLT and non-OLT) of patients affected by IBD and PSC. An observational, multicentre, cohort retrospective study was conducted by the Italian Group for the study of IBD in Italy. The primary outcome was the need for biologic therapy or bowel resection for medically refractory IBD or hospitalization due to IBD relapse during the follow-up. Secondary outcomes were rate of colonic dysplasia, colorectal cancer, other solid tumours, lymphoma. Eighty-four patients were included in the study. The primary outcome was not different between OLT and non-OLT groups (11/27, 40.7%, versus 20/57, 35.1%, respectively, p = 0.62). The lymphoma and other tumours (thyroid cancer, kidney cancer, ileal tumour, ovarian cancer, cervical cancer) rates were significantly higher in the OLT group (p = 0.04 and p = 0.005, respectively), at the limit of statistical significance for high-grade colonic dysplasia (p = 0.06). OLT in patients affected by IBD and PSC is not a risk factor for a more severe IBD course, but it is associated with a higher occurrence of cancer.

Sections du résumé

BACKGROUND
Data regarding the effect of orthotopic liver transplantation (OLT) for primary sclerosing cholangitis (PSC) on inflammatory bowel disease (IBD) course are scarce and conflicting.
AIMS
To compare the incidence of refractory IBD in two groups (OLT and non-OLT) of patients affected by IBD and PSC.
METHODS
An observational, multicentre, cohort retrospective study was conducted by the Italian Group for the study of IBD in Italy. The primary outcome was the need for biologic therapy or bowel resection for medically refractory IBD or hospitalization due to IBD relapse during the follow-up. Secondary outcomes were rate of colonic dysplasia, colorectal cancer, other solid tumours, lymphoma.
RESULTS
Eighty-four patients were included in the study. The primary outcome was not different between OLT and non-OLT groups (11/27, 40.7%, versus 20/57, 35.1%, respectively, p = 0.62). The lymphoma and other tumours (thyroid cancer, kidney cancer, ileal tumour, ovarian cancer, cervical cancer) rates were significantly higher in the OLT group (p = 0.04 and p = 0.005, respectively), at the limit of statistical significance for high-grade colonic dysplasia (p = 0.06).
CONCLUSION
OLT in patients affected by IBD and PSC is not a risk factor for a more severe IBD course, but it is associated with a higher occurrence of cancer.

Identifiants

pubmed: 32972831
pii: S1590-8658(20)30503-X
doi: 10.1016/j.dld.2020.09.011
pii:
doi:

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

712-716

Informations de copyright

Copyright © 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of interest None declared.

Auteurs

Davide Giuseppe Ribaldone (DG)

Department of Medical Sciences, Division of Gastroenterology, University of Torino, Torino, Italy. Electronic address: davrib_1998@yahoo.com.

Nicola Imperatore (N)

Gastroenterology Unit, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy; Gastroenterology and Endoscopy Unit, AORN Antonio Cardarelli, Naples, Italy.

Marco Le Grazie (M)

IBD Referral Center, Gastroenterology Department, Careggi University Hospital, Florence, Italy.

Federica Furfaro (F)

Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy.

Paola Balestrieri (P)

Unit of Gastroenterology, Campus Bio-Medico University, Rome, Italy.

Federico De Blasio (F)

Department of Medical Sciences, Division of Gastroenterology, University of Torino, Torino, Italy.

Sharmila Fagoonee (S)

Institute of Biostructure and Bioimaging (CNR), Molecular Biotechnology Center, Turin, Italy.

Elena Mosso (E)

Department of Medical Sciences, Division of Gastroenterology, University of Torino, Torino, Italy.

Valentina Boano (V)

Department of Medical Sciences, Division of Gastroenterology, University of Torino, Torino, Italy.

Dario Reggio (D)

General Surgery 2U, Liver Transplant Center, Department of Surgical Sciences, University of Turin, Turin, Italy.

Ennio Sarli (E)

Italian Group for the study of Inflammatory Bowel Disease IG-IBD, Florence, Italy.

Fabiana Castiglione (F)

Gastroenterology Unit, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy.

Monica Milla (M)

IBD Referral Center, Gastroenterology Department, Careggi University Hospital, Florence, Italy.

Maurizio Vecchi (M)

Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Italy.

Giorgio Maria Saracco (GM)

Department of Medical Sciences, Division of Gastroenterology, University of Torino, Torino, Italy.

Mauro Salizzoni (M)

General Surgery 2U, Liver Transplant Center, Department of Surgical Sciences, University of Turin, Turin, Italy.

Renato Romagnoli (R)

General Surgery 2U, Liver Transplant Center, Department of Surgical Sciences, University of Turin, Turin, Italy.

Gionata Fiorino (G)

Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.

Marco Astegiano (M)

Department of General and Specialist Medicine, Gastroenterologia-U, Città della Salute e della Scienza di Torino, Turin, Italy.
Italian Group for the study of Inflammatory Bowel Disease IG-IBD, Florence, Italy.

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Classifications MeSH