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P235. Does liver transplantation affect the risk for colorectal neoplasia in PSC-IBD patients?

J. Maljaars, K. Sebib Korkmaz, A. Van der Meulen, B. van Hoek, Leiden University Medical Center, Gastroenterology and Hepatology, Leiden, Netherlands

Background

In IBD, primary sclerosing cholangitis (PSC) confers an increased risk of colorectal neoplasia (CRN). The aim of this study was to evaluate the effect of liver transplantation (LT) on development of CRN in patients with PSC and IBD.

Methods

From our LT cohort (n = 275, period 1992–2011), 21 patients were identified with PSC and IBD and a follow-up post LT >6 months (PSC+LT). We further identified 39 patients with PSC and IBD without LT (PSC). In these patients with PSC and IBD, we performed a Cox regression analysis with LT as a time-dependent covariate.

We additionally compared development of CRN after LT between patients with PSC and IBD and the non-PSC LT population. To this end, we compared PSC+LT to a group of LT patients without PSC or IBD that was matched for sex, age and duration of post LT follow up (LT).

Results

In patients with PSC, LT increased the risk of CRN in PSC patients with IBD in the univariate analysis; this effect was no longer present in the multivariate analysis. Cumulative incidence of CRN was 29% in the PSC+LT group vs. 10% in the PSC group (ns).

CRN-free survival did not differ between PSC+LT and LT groups. Cumulative incidence of CRN for the groups was similar (resp. 29% vs. 32%, ns).

Conclusion

Liver transplantation did not increase the rate of CRN in patients with both PSC and IBD. Furthermore, the rate of development of CRN did not differ between PSC+LT patients and the general LT population.