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.
Original language | English |
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Pages (from-to) | 269-276 |
Number of pages | 8 |
Journal | Inflammatory Bowel Diseases |
Volume | 24 |
Issue number | 2 |
DOIs | |
State | Published - 18 Jan 2018 |
Externally published | Yes |
Keywords
- 5 aminosalicylates
- inflammatory bowel disease
- liver transplantation
- primary sclerosing cholangitis
- ursodeoxycholic acid