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Screening colonoscopy in liver transplant candidates: risks and findings.
- Source :
-
Clinical Transplantation . Mar/Apr2013, Vol. 27 Issue 2, pE161-E168. 8p. 1 Color Photograph, 1 Diagram, 2 Charts. - Publication Year :
- 2013
-
Abstract
- The indication for mandatory screening colonoscopies in liver transplant candidates is controversial. Since the introduction of MELD-based allocation, patients with advanced liver disease and often severe comorbidities are prioritized for liver transplantation ( LT). This study evaluated safety and outcome of colonoscopy in this high-risk patient group. During a two-yr period, we performed 243 colonoscopies in potential LT candidates. Endoscopic findings were registered in a standardized form, and correlations with biochemical or clinical parameters were analyzed using Mann- Whitney U-test and chi-square test. Only 57 patients (23.5%) had an endoscopically normal colon. Main findings were polyps (45.7%), hypertensive colopathy (24.3%), diverticulosis (21%), rectal varices (19.8%), and hemorrhoids (13.6%). In 21% of all patients, the removed polyps were diagnosed as adenomas. The prevalence of neoplastic polyps increased significantly with age: 13.6% (patients <50 yr) vs. 25% (patients ≥50 yr) (p = 0.03). Advanced neoplasia was found only in patients older than 40 yr. No major complications were observed; post-interventional hemorrhage was observed in 1.7% and controlled by clipping or injection therapy. In conclusion, lower gastrointestinal endoscopy is safe and effective in LT candidates. Due to the age dependency of neoplastic polyps, a screening colonoscopy should be performed in LT candidates older than 40 yr or with symptoms or additional risk factors. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09020063
- Volume :
- 27
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Clinical Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 86745571
- Full Text :
- https://doi.org/10.1111/ctr.12083