1. Post-transplant colitis after kidney transplantation: clinical, endoscopic and histological features.
- Author
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Gioco R, Puzzo L, Patanè M, Corona D, Trama G, Veroux P, and Veroux M
- Subjects
- Adenoma diagnosis, Age Distribution, Aged, Anemia, Colitis chemically induced, Colitis diagnosis, Colonoscopy, Colorectal Neoplasms diagnosis, Diarrhea, Diverticulosis, Colonic diagnosis, Diverticulosis, Colonic epidemiology, Early Detection of Cancer, Female, Gastrointestinal Hemorrhage, Humans, Incidence, Inflammatory Bowel Diseases diagnosis, Male, Middle Aged, Mycophenolic Acid adverse effects, Tacrolimus adverse effects, Time Factors, Adenoma epidemiology, Colitis epidemiology, Colorectal Neoplasms epidemiology, Graft Rejection prevention & control, Immunosuppressive Agents adverse effects, Inflammatory Bowel Diseases epidemiology, Kidney Failure, Chronic surgery, Kidney Transplantation
- Abstract
Chronic immunosuppression may increase the risk of post-transplant infection and medication-related injury and may also be responsible for the increased risk of gastrointestinal complications in kidney transplant recipients. Differentiating the various forms of post-transplant colitis is challenging, since most have similar clinical and histological features. This study evaluated the incidence of post-transplant gastrointestinal complications during screening colonoscopy. Kidney transplant recipients undergoing a colonoscopy for any reasons in the period 2014-2018 were included. Among the 134 patients completing the colonoscopy, 74 patients (56%) had an abnormal finding: an adenoma was found in 25 patients (18.6%), while 19 patients (14.1%) had colitis. Mycophenolic acid/related colitis was the most common colitis (6%), while 7 patients (5.2%) developed a de novo inflammatory bowel disease. Patients with post-transplant colitis were younger and with shorter time from transplant compared to patients without colitis. In conclusions, immunosuppression may predispose kidney transplant recipients to an increased risk of post-transplant colitis. Diagnostic colonoscopy should be encouraged in all transplant patients with refractory diarrhea and gastrointestinal symptoms to allow a prompt diagnosis and a timely treatment, finally improving the quality of life and long-term outcomes of affected patients.
- Published
- 2020
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