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P151. Risk of colorectal cancer in patients with ulcerative colitis after orthotopic liver transplantation for primary sclerosing cholangitis – a single center experience

P. Drastich1, P. Wohl1, D. Kamenar1, P. Trunecka2, J. Spicak1

1Institute for Clinical and Experimental Medicine, Hepatogastroenterology, Prague, Czech Republic; 2Institute for Clinical and Experimental Medicine, Transplantcentre, Prague, Czech Republic

Background: A markedly increased risk of colorectal cancer (CRC) is well established in patients with primary sclerosing cholangitis (PSC) with associated ulcerative colitis (UC). The incidence of colorectal cancer appears to be even higher after orthotopic liver transplantation (OLTx) but published studies still provide contrasting data.

Methods: A total of 673 liver transplants were performed in IKEM (Czech Republic) between 1995 and 2009. We analyzed 82 consecutive patients with PSC (12.1% of all OLTx) with mean age 47±13.2 years who survived more than 12 months. UC was diagnosed in 65 patients (79.3%); two patients suffered from Crohn's disease (2.4%). Colonoscopy was performed in all patients before OLTx and annually after OLTx with extent biopsies. The analysis includes 69 patients as 7 died and 6 patients were lost from follow up in our center. Patients were studied over median follow up period of 72 months (range 20–208) after OLTx.

Results: Low-grade dysplasia (LGD) of colonic mucosa was found during follow up period in 8/69 (11.6%) patients after OLTx. High-grade dysplasia was detected in DALM lesion just in one patient followed by colectomy. CRC was detected in one patient after OLTx, but colectomy was already scheduled because of high-grade dysplasia confirmed in DALM lesion before transplantation.

Conclusions: We did not find increased frequency of dysplastic/neoplastic changes of colonic mucosa after OLTx.