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The Course of Ulcerative Colitis After Pediatric Liver Transplantation for Sclerosing Cholangitis.

Abstract：

BACKGROUND:Primary sclerosing cholangitis (PSC) and autoimmune sclerosing cholangitis (ASC) are often associated with ulcerative colitis (UC). The impact on the course of UC remains unclear, and up-to-date evidence in pediatric populations is scarce. The aim of the study was to analyze the course of UC in pediatric patients transplanted owing to PSC or ASC. MATERIAL AND METHODS:We retrospectively reviewed data from children with PSC/ASC and UC who underwent orthotopic liver transplantation (OLT). In all patients UC diagnosis was based on clinical presentation, endoscopy, and histology. RESULTS:Seventeen patients (9 female) with PSC or ASC underwent OLT from deceased donors at a median age of 16.8 years (range = 11.5-18.2 years). In 15 patients, UC was diagnosed before OLT (median age of diagnosis = 10.6 years; range = 6.6-18.0 years), and 2 patients developed UC after OLT. Ten patients (59%) presented with pancolitis on initial endoscopy. Disease activity was severe in 9 patients (53%) and most patients improved after initial treatment with steroids. Before OLT only 2 patients (13%) had severe disease activity. After OLT, 4 patients developed flares of the disease. These patients were successfully treated and remained in remission at the end of the posttransplant follow-up period (median = 3.76 years; range = 0.4-15.5 years). None of the patients developed colorectal cancer or underwent colectomy during 3.7 years of post-OLT follow-up. CONCLUSION:In our experience, the course of UC was not aggravated by OLT for PSC, and UC did not adversely affect patient or graft survival.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Osiecki M,Kierkuś J,Pawłowska J,Woźniak M,Jankowska I,Teisseyre M,Dądalski M,Jarzębicka D,Stefanowicz M,Czubkowski P

doi

10.1016/j.transproceed.2020.09.011

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

244-249

issue

1

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(20)30468-1

journal_volume

53

pub_type

杂志文章

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