Research Paper Volume 12, Issue 24 pp 24709—24720
Post-transplant colitis after kidney transplantation: clinical, endoscopic and histological features
- 1 General Surgery Unit, University Hospital of Catania, Catania 95123, Italy
- 2 Pathology Unit, Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania 95123, Italy
- 3 Organ Transplant Unit, University Hospital of Catania, Catania 95123, Italy
- 4 Department of Biomedical and Biotechnological Sciences, University of Catania, Catania 95123, Italy
- 5 Gastroenterology Unit, University Hospital of Catania, Catania 95123, Italy
Received: October 10, 2020 Accepted: November 16, 2020 Published: December 22, 2020
https://doi.org/10.18632/aging.202345How to Cite
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.