Title

Reviewing the Risk of Colorectal Cancer in Inflammatory Bowel Disease After Liver Trasnplantation for Primary Sclerosing Cholangitis.

Document Type

Article

Publication Date

1-18-2018

Keywords

5 aminosalicylates; inflammatory bowel disease; liver transplantation; primary sclerosing cholangitis; ursodeoxycholic acid

Abstract

The presence of concomitant primary sclerosing cholangitis (PSC) with inflammatory bowel disease (IBD) represents a distinct disease phenotype that carries a higher risk of colorectal cancer (CRC) than the average IBD patient. Given that liver transplantation (LT) is the only treatment that offers a survival benefit in PSC patients with hepatic dysfunction, management decisions in IBD patients' post-LT for PSC are frequently encountered. One such consideration is the risk of CRC in this immunosuppressed cohort. With most studies showing an increased risk of CRC post-LT in these IBD patients, a closer look at the associated risk factors of CRC and the adopted surveillance strategies in this subset of patients is warranted. Low-dose ursodeoxycholic acid has shown a potential chemopreventive effect in PSC-IBD patients pre-LT; however, a favorable effect remains to be seen in post-LT group. Also, further studies are necessary to assess the benefit of 5 aminosalicylate therapy. Annual surveillance colonoscopy in the post-LT period is recommended for PSC-IBD patients subset given their high risk for CRC.

Clinical Institute

Digestive Health

Clinical Institute

Cancer

Department

Gastroenterology

Department

Oncology

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