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The effects of liver transplantation on the clinical course of colitis in ulcerative colitis patients with primary sclerosing cholangitis
Summary Background The course of ulcerative colitis (UC) following orthotopic liver transplantation (OLT) for primary sclerosing cholangitis (PSC) is unclear. Aim To investigate the clinical course of UC, before and after OLT for PSC. Methods From a historical cohort of 86 patients with PSC‐UC who u...
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| Published in: | Alimentary pharmacology & therapeutics 2012-05, Vol.35 (9), p.1054-1063 |
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| container_end_page | 1063 |
| container_issue | 9 |
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| container_title | Alimentary pharmacology & therapeutics |
| container_volume | 35 |
| creator | Navaneethan, U. Choudhary, M. Venkatesh, P. G. K. Lashner, B. A. Remzi, F. H. Shen, B. Kiran, R. P. |
| description | Summary
Background
The course of ulcerative colitis (UC) following orthotopic liver transplantation (OLT) for primary sclerosing cholangitis (PSC) is unclear.
Aim
To investigate the clinical course of UC, before and after OLT for PSC.
Methods
From a historical cohort of 86 patients with PSC‐UC who underwent OLT, 77 patients who were followed up at our institution both before and after OLT from 1985 to 2011 were included.
Results
Ulcerative colitis was diagnosed in 77 (97.5%) patients before OLT. Nineteen of 77 (24.7%) patients underwent colectomy before OLT. In the other 58 patients, the course of UC after OLT when compared to the last 5 years before OLT was quiescent in 48 patients (82.8%) while 9/58 (15.5%) of patients underwent colectomy post‐OLT. There was a total of 97 colitis flares over a total of 621 years of follow‐up from PSC/UC diagnosis to OLT (0.156 flares per patient year) whereas post‐OLT, there were 31 flares over a total of 511 years of post‐OLT follow‐up (0.061 flares per patient year) (P |
| doi_str_mv | 10.1111/j.1365-2036.2012.05067.x |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1552370511</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1552370511</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5207-264d4200d35f0197f7038e386630e9312570b377960d30e8ee8b3885669d79553</originalsourceid><addsrcrecordid>eNqNkc9uEzEQxi0EoqHwCsgXJC67jO3Y3j1wqAq0qBH0EFRu1saZbRyc3dT2tukj8NZ4mxCuWJb87_fNjL8hhDIoWR4f1iUTShYchCo5MF6CBKXL3TMyOT48JxPgqi54xcQJeRXjGiBDwF-SE86nvNKCTcjv-Qopti3aFGnfUu_uMdAUmi5ufdOlJrm-o3mmzFnvOmcbT20_hIgjb3vvkovUdXTwFkPm7_F4u81H7HLkB5dWdBvcpgmPNFqPoY-uu6V21ecstyP8mrxoGx_xzWE9JT--fJ6fXxaz7xdfz89mhZUcdMHVdDnlAEshW2C1bjWICkWllACsBeNSw0JoXauMAFaI1UJUlVSqXupaSnFK3u_jbkN_N2BMZuOiRZ_rwH6IhknJhQbJWEarPWpzuTFgaw5fMAzM2AizNqPfZvTbjI0wT40wuyx9e8gyLDa4PAr_Op-BdwegidnSNjtuXfzHSc2VBJ25j3vuwXl8_O8CzNn1fNxlfbHXu5hwd9Q34ZfJr1qam28XZnbDLn9-ur4yM_EHLC-0BA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1552370511</pqid></control><display><type>article</type><title>The effects of liver transplantation on the clinical course of colitis in ulcerative colitis patients with primary sclerosing cholangitis</title><source>Wiley:Jisc Collections:Wiley Read and Publish Open Access 2024-2025 (reading list)</source><creator>Navaneethan, U. ; Choudhary, M. ; Venkatesh, P. G. K. ; Lashner, B. A. ; Remzi, F. H. ; Shen, B. ; Kiran, R. P.</creator><creatorcontrib>Navaneethan, U. ; Choudhary, M. ; Venkatesh, P. G. K. ; Lashner, B. A. ; Remzi, F. H. ; Shen, B. ; Kiran, R. P.</creatorcontrib><description>Summary
Background
The course of ulcerative colitis (UC) following orthotopic liver transplantation (OLT) for primary sclerosing cholangitis (PSC) is unclear.
Aim
To investigate the clinical course of UC, before and after OLT for PSC.
Methods
From a historical cohort of 86 patients with PSC‐UC who underwent OLT, 77 patients who were followed up at our institution both before and after OLT from 1985 to 2011 were included.
Results
Ulcerative colitis was diagnosed in 77 (97.5%) patients before OLT. Nineteen of 77 (24.7%) patients underwent colectomy before OLT. In the other 58 patients, the course of UC after OLT when compared to the last 5 years before OLT was quiescent in 48 patients (82.8%) while 9/58 (15.5%) of patients underwent colectomy post‐OLT. There was a total of 97 colitis flares over a total of 621 years of follow‐up from PSC/UC diagnosis to OLT (0.156 flares per patient year) whereas post‐OLT, there were 31 flares over a total of 511 years of post‐OLT follow‐up (0.061 flares per patient year) (P < 0.001). On univariable analysis, the number of UC flares [Odds ratio (OR) 1.52; 95% Confidence interval (1.02–2.27), P = 0.04] and dysplasia [OR 47.00; 95% CI (6.48–340.66), P < 0.001] increased the risk of colectomy following OLT; the use of corticosteroids [OR 0.07; 95% CI (0.01–0.63), P = 0.008] and 5‐aminosalicylate [OR 0.18; 95% CI (0.04–0.83), P = 0.04] was protective.
Conclusions
Ulcerative colitis in the presence of primary sclerosing cholangitis remains quiescent, and may improve in most patients after orthotopic liver transplantation.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/j.1365-2036.2012.05067.x</identifier><identifier>PMID: 22428731</identifier><language>eng</language><publisher>Oxford: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Cholangitis, Sclerosing - physiopathology ; Cholangitis, Sclerosing - surgery ; Cohort Studies ; Colectomy - methods ; Colitis, Ulcerative - complications ; Colitis, Ulcerative - physiopathology ; Colitis, Ulcerative - surgery ; Digestive system ; Female ; Follow-Up Studies ; Gastroenterology. Liver. Pancreas. Abdomen ; Glucocorticoids - therapeutic use ; Humans ; Liver Transplantation - methods ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Male ; Medical sciences ; Mesalamine - therapeutic use ; Middle Aged ; Other diseases. Semiology ; Pharmacology. Drug treatments ; Retrospective Studies ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><ispartof>Alimentary pharmacology & therapeutics, 2012-05, Vol.35 (9), p.1054-1063</ispartof><rights>2012 Blackwell Publishing Ltd</rights><rights>2015 INIST-CNRS</rights><rights>2012 Blackwell Publishing Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5207-264d4200d35f0197f7038e386630e9312570b377960d30e8ee8b3885669d79553</citedby><cites>FETCH-LOGICAL-c5207-264d4200d35f0197f7038e386630e9312570b377960d30e8ee8b3885669d79553</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25726507$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22428731$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Navaneethan, U.</creatorcontrib><creatorcontrib>Choudhary, M.</creatorcontrib><creatorcontrib>Venkatesh, P. G. K.</creatorcontrib><creatorcontrib>Lashner, B. A.</creatorcontrib><creatorcontrib>Remzi, F. H.</creatorcontrib><creatorcontrib>Shen, B.</creatorcontrib><creatorcontrib>Kiran, R. P.</creatorcontrib><title>The effects of liver transplantation on the clinical course of colitis in ulcerative colitis patients with primary sclerosing cholangitis</title><title>Alimentary pharmacology & therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary
Background
The course of ulcerative colitis (UC) following orthotopic liver transplantation (OLT) for primary sclerosing cholangitis (PSC) is unclear.
Aim
To investigate the clinical course of UC, before and after OLT for PSC.
Methods
From a historical cohort of 86 patients with PSC‐UC who underwent OLT, 77 patients who were followed up at our institution both before and after OLT from 1985 to 2011 were included.
Results
Ulcerative colitis was diagnosed in 77 (97.5%) patients before OLT. Nineteen of 77 (24.7%) patients underwent colectomy before OLT. In the other 58 patients, the course of UC after OLT when compared to the last 5 years before OLT was quiescent in 48 patients (82.8%) while 9/58 (15.5%) of patients underwent colectomy post‐OLT. There was a total of 97 colitis flares over a total of 621 years of follow‐up from PSC/UC diagnosis to OLT (0.156 flares per patient year) whereas post‐OLT, there were 31 flares over a total of 511 years of post‐OLT follow‐up (0.061 flares per patient year) (P < 0.001). On univariable analysis, the number of UC flares [Odds ratio (OR) 1.52; 95% Confidence interval (1.02–2.27), P = 0.04] and dysplasia [OR 47.00; 95% CI (6.48–340.66), P < 0.001] increased the risk of colectomy following OLT; the use of corticosteroids [OR 0.07; 95% CI (0.01–0.63), P = 0.008] and 5‐aminosalicylate [OR 0.18; 95% CI (0.04–0.83), P = 0.04] was protective.
Conclusions
Ulcerative colitis in the presence of primary sclerosing cholangitis remains quiescent, and may improve in most patients after orthotopic liver transplantation.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cholangitis, Sclerosing - physiopathology</subject><subject>Cholangitis, Sclerosing - surgery</subject><subject>Cohort Studies</subject><subject>Colectomy - methods</subject><subject>Colitis, Ulcerative - complications</subject><subject>Colitis, Ulcerative - physiopathology</subject><subject>Colitis, Ulcerative - surgery</subject><subject>Digestive system</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Humans</subject><subject>Liver Transplantation - methods</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mesalamine - therapeutic use</subject><subject>Middle Aged</subject><subject>Other diseases. Semiology</subject><subject>Pharmacology. Drug treatments</subject><subject>Retrospective Studies</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><issn>0269-2813</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNqNkc9uEzEQxi0EoqHwCsgXJC67jO3Y3j1wqAq0qBH0EFRu1saZbRyc3dT2tukj8NZ4mxCuWJb87_fNjL8hhDIoWR4f1iUTShYchCo5MF6CBKXL3TMyOT48JxPgqi54xcQJeRXjGiBDwF-SE86nvNKCTcjv-Qopti3aFGnfUu_uMdAUmi5ufdOlJrm-o3mmzFnvOmcbT20_hIgjb3vvkovUdXTwFkPm7_F4u81H7HLkB5dWdBvcpgmPNFqPoY-uu6V21ecstyP8mrxoGx_xzWE9JT--fJ6fXxaz7xdfz89mhZUcdMHVdDnlAEshW2C1bjWICkWllACsBeNSw0JoXauMAFaI1UJUlVSqXupaSnFK3u_jbkN_N2BMZuOiRZ_rwH6IhknJhQbJWEarPWpzuTFgaw5fMAzM2AizNqPfZvTbjI0wT40wuyx9e8gyLDa4PAr_Op-BdwegidnSNjtuXfzHSc2VBJ25j3vuwXl8_O8CzNn1fNxlfbHXu5hwd9Q34ZfJr1qam28XZnbDLn9-ur4yM_EHLC-0BA</recordid><startdate>201205</startdate><enddate>201205</enddate><creator>Navaneethan, U.</creator><creator>Choudhary, M.</creator><creator>Venkatesh, P. G. K.</creator><creator>Lashner, B. A.</creator><creator>Remzi, F. H.</creator><creator>Shen, B.</creator><creator>Kiran, R. P.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201205</creationdate><title>The effects of liver transplantation on the clinical course of colitis in ulcerative colitis patients with primary sclerosing cholangitis</title><author>Navaneethan, U. ; Choudhary, M. ; Venkatesh, P. G. K. ; Lashner, B. A. ; Remzi, F. H. ; Shen, B. ; Kiran, R. P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5207-264d4200d35f0197f7038e386630e9312570b377960d30e8ee8b3885669d79553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cholangitis, Sclerosing - physiopathology</topic><topic>Cholangitis, Sclerosing - surgery</topic><topic>Cohort Studies</topic><topic>Colectomy - methods</topic><topic>Colitis, Ulcerative - complications</topic><topic>Colitis, Ulcerative - physiopathology</topic><topic>Colitis, Ulcerative - surgery</topic><topic>Digestive system</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Glucocorticoids - therapeutic use</topic><topic>Humans</topic><topic>Liver Transplantation - methods</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mesalamine - therapeutic use</topic><topic>Middle Aged</topic><topic>Other diseases. Semiology</topic><topic>Pharmacology. Drug treatments</topic><topic>Retrospective Studies</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Navaneethan, U.</creatorcontrib><creatorcontrib>Choudhary, M.</creatorcontrib><creatorcontrib>Venkatesh, P. G. K.</creatorcontrib><creatorcontrib>Lashner, B. A.</creatorcontrib><creatorcontrib>Remzi, F. H.</creatorcontrib><creatorcontrib>Shen, B.</creatorcontrib><creatorcontrib>Kiran, R. P.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Navaneethan, U.</au><au>Choudhary, M.</au><au>Venkatesh, P. G. K.</au><au>Lashner, B. A.</au><au>Remzi, F. H.</au><au>Shen, B.</au><au>Kiran, R. P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effects of liver transplantation on the clinical course of colitis in ulcerative colitis patients with primary sclerosing cholangitis</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2012-05</date><risdate>2012</risdate><volume>35</volume><issue>9</issue><spage>1054</spage><epage>1063</epage><pages>1054-1063</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><abstract>Summary
Background
The course of ulcerative colitis (UC) following orthotopic liver transplantation (OLT) for primary sclerosing cholangitis (PSC) is unclear.
Aim
To investigate the clinical course of UC, before and after OLT for PSC.
Methods
From a historical cohort of 86 patients with PSC‐UC who underwent OLT, 77 patients who were followed up at our institution both before and after OLT from 1985 to 2011 were included.
Results
Ulcerative colitis was diagnosed in 77 (97.5%) patients before OLT. Nineteen of 77 (24.7%) patients underwent colectomy before OLT. In the other 58 patients, the course of UC after OLT when compared to the last 5 years before OLT was quiescent in 48 patients (82.8%) while 9/58 (15.5%) of patients underwent colectomy post‐OLT. There was a total of 97 colitis flares over a total of 621 years of follow‐up from PSC/UC diagnosis to OLT (0.156 flares per patient year) whereas post‐OLT, there were 31 flares over a total of 511 years of post‐OLT follow‐up (0.061 flares per patient year) (P < 0.001). On univariable analysis, the number of UC flares [Odds ratio (OR) 1.52; 95% Confidence interval (1.02–2.27), P = 0.04] and dysplasia [OR 47.00; 95% CI (6.48–340.66), P < 0.001] increased the risk of colectomy following OLT; the use of corticosteroids [OR 0.07; 95% CI (0.01–0.63), P = 0.008] and 5‐aminosalicylate [OR 0.18; 95% CI (0.04–0.83), P = 0.04] was protective.
Conclusions
Ulcerative colitis in the presence of primary sclerosing cholangitis remains quiescent, and may improve in most patients after orthotopic liver transplantation.</abstract><cop>Oxford</cop><pub>Blackwell Publishing Ltd</pub><pmid>22428731</pmid><doi>10.1111/j.1365-2036.2012.05067.x</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| source | Wiley:Jisc Collections:Wiley Read and Publish Open Access 2024-2025 (reading list) |
| subjects | Adult Aged Biological and medical sciences Cholangitis, Sclerosing - physiopathology Cholangitis, Sclerosing - surgery Cohort Studies Colectomy - methods Colitis, Ulcerative - complications Colitis, Ulcerative - physiopathology Colitis, Ulcerative - surgery Digestive system Female Follow-Up Studies Gastroenterology. Liver. Pancreas. Abdomen Glucocorticoids - therapeutic use Humans Liver Transplantation - methods Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical sciences Mesalamine - therapeutic use Middle Aged Other diseases. Semiology Pharmacology. Drug treatments Retrospective Studies Stomach. Duodenum. Small intestine. Colon. Rectum. Anus |
| title | The effects of liver transplantation on the clinical course of colitis in ulcerative colitis patients with primary sclerosing cholangitis |
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