Kang, Eun Ae; Koh, Seong-Joon; Kim, Ji Won; Lee, Kook Lae; Im, Jong Pil; Kim, Joo Sung; Kim, Byeong Gwan
The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology
2018May ; 29 ( 3 ) :316-324.
PMID : 29755016
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Kang, Eun Ae - Department of Internal Medicine and Liver Research Institute, Seoul National University School of Medicine, Seoul, Korea.
Koh, Seong-Joon - Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University School of Medicine, Seoul, Korea.
Kim, Ji Won - Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University School of Medicine, Seoul, Korea.
Lee, Kook Lae - Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University School of Medicine, Seoul, Korea.
Im, Jong Pil - Department of Internal Medicine and Liver Research Institute, Seoul National University School of Medicine, Seoul, Korea.
Kim, Joo Sung - Department of Internal Medicine and Liver Research Institute, Seoul National University School of Medicine, Seoul, Korea.
Kim, Byeong Gwan - Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University School of Medicine, Seoul, Korea.
ABSTRACT
BACKGROUND/AIMS: Patients with liver transplantation are at increased risk of developing new malignancy because of the prolonged immunosuppression after transplantation. The aims of this study were to investigate whether advanced colorectal neoplasms occurs more in liver transplant recipients compared to healthy individuals and to evaluate the effect of immunosuppression on advanced colorectal neoplasia. MATERIALS AND
METHODS: This was a retrospective, single-centered, case-control study. We reviewed 348 liver transplant patients who had undergone a colonoscopy after liver transplantation from 1991 to 2012. Healthy controls from asymptomatic individuals who had undergone colonoscopy for screening purposes were randomly selected and reviewed.
RESULTS: Advanced colorectal neoplasms were identified in 17 of the 348 patients (4.9%). The risk of advanced colorectal neoplasia was 3.6 times greater in liver transplant patients (odds ratio [OR] 3.578; 95% confidence interval [CI] 1.578-8.115; p=0.001). The risk of developing colon cancer was 8.4 times higher in transplant patients (OR 8.416; 95% CI 1.808-39.172; p=0.001). CONCLUSION: Liver transplant recipients were at a high risk of colorectal cancer. Therefore, colonoscopy surveillance after liver transplantation is recommended. Immunosuppressive therapy could facilitate carcinogenesis.
Liver transplantation, colorectal neoplasms, adenoma, immunosuppression
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