Do Patients Need More Frequent Colonoscopic Surveillance After Liver Transplantation?

M. Rudraraju, A. T. Osowo, V. Singh, E. J. Carey

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Solid-organ transplant recipients are at higher risk for developing malignancies believed to be due to the use of immunosuppression. The aim of our study was to determine the risk of development of colon polyps with advanced features and colon carcinoma in liver transplant (LT) recipients when compared to individuals with chronic liver disease (CLD) and individuals without liver disease. Methods: Case-control analyses of 82 LT recipients who underwent posttransplant colonoscopy, matched for age, gender, and year of colonoscopy, were compared to 82 patients with chronic liver disease and 82 patients without liver disease undergoing screening colonoscopy. Incidence of advanced adenomas (polyps >1 cm, high-grade dysplasia, villous histology) and colon carcinoma was documented. Results: The groups were similar in age and gender, but there were more Hispanic patients in the LT group. Six patients (7.3%) of the LT group, 3 patients (3.6%) of the chronic liver disease group, and 1 patient (1.2%) of the no-liver-disease group had the outcome of interest, but the P value was not significant. Immunosuppression used was tacrolimus and mycophenolate in 2 patients, tacrolimus-only in 2 patients, and cyclosporine in 2 patients. Conclusions: There is a trend toward increased incidence of advanced colon polyps and colon carcinoma in immunosuppressed patients after liver transplantation. Larger studies are needed to determine whether posttransplant colon cancer surveillance should be more frequent than currently recommended for nontransplant patients.

Original languageEnglish (US)
Pages (from-to)1522-1524
Number of pages3
JournalTransplantation Proceedings
Volume40
Issue number5
DOIs
StatePublished - Jun 2008

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Liver Transplantation
Liver Diseases
Colon
Colonoscopy
Polyps
Chronic Disease
Liver
Tacrolimus
Carcinoma
Transplants
Immunosuppression
Incidence
Hispanic Americans
Adenoma
Colonic Neoplasms
Cyclosporine
Histology

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Do Patients Need More Frequent Colonoscopic Surveillance After Liver Transplantation? / Rudraraju, M.; Osowo, A. T.; Singh, V.; Carey, E. J.

In: Transplantation Proceedings, Vol. 40, No. 5, 06.2008, p. 1522-1524.

Research output: Contribution to journalArticle

Rudraraju, M. ; Osowo, A. T. ; Singh, V. ; Carey, E. J. / Do Patients Need More Frequent Colonoscopic Surveillance After Liver Transplantation?. In: Transplantation Proceedings. 2008 ; Vol. 40, No. 5. pp. 1522-1524.
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abstract = "Background: Solid-organ transplant recipients are at higher risk for developing malignancies believed to be due to the use of immunosuppression. The aim of our study was to determine the risk of development of colon polyps with advanced features and colon carcinoma in liver transplant (LT) recipients when compared to individuals with chronic liver disease (CLD) and individuals without liver disease. Methods: Case-control analyses of 82 LT recipients who underwent posttransplant colonoscopy, matched for age, gender, and year of colonoscopy, were compared to 82 patients with chronic liver disease and 82 patients without liver disease undergoing screening colonoscopy. Incidence of advanced adenomas (polyps >1 cm, high-grade dysplasia, villous histology) and colon carcinoma was documented. Results: The groups were similar in age and gender, but there were more Hispanic patients in the LT group. Six patients (7.3{\%}) of the LT group, 3 patients (3.6{\%}) of the chronic liver disease group, and 1 patient (1.2{\%}) of the no-liver-disease group had the outcome of interest, but the P value was not significant. Immunosuppression used was tacrolimus and mycophenolate in 2 patients, tacrolimus-only in 2 patients, and cyclosporine in 2 patients. Conclusions: There is a trend toward increased incidence of advanced colon polyps and colon carcinoma in immunosuppressed patients after liver transplantation. Larger studies are needed to determine whether posttransplant colon cancer surveillance should be more frequent than currently recommended for nontransplant patients.",
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