Feasibility and findings of colonoscopy for living-donor liver transplant candidates

Shin Ishikawa, Jun Kato, Motoaki Kuriyama, Koji Takemoto, Toshio Uraoka, Akinobu Takaki, Takahito Yagi, Kohsaku Sakaguchi

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

BACKGROUND AND AIMS: Living-donor liver transplantation (LDLT) has been widely performed in patients with end-stage liver disease and hepatocellular carcinoma in Japan. Although extrahepatic cancer survey for LDLT candidates is absolutely required, few reports have indicated the optimal surveillance method for colorectal cancer. The aim of this study is to investigate the feasibility and findings of colonoscopy before LDLT. PATIENTS AND METHODS: From January 2004 to August 2006, we prospectively enrolled all of the scheduled LDLT candidates of our hospital for pretransplant colonoscopy examination. RESULTS: A total of 81 patients were enrolled for colonoscopy. Of these patients, 67 (83%) could actually undergo colonoscopy. Patients who could not undergo colonoscopy exhibited more impaired liver function than those who could (median Model End-Stage Liver Disease score; 25.5 vs. 14.5, P=0.0003). Among patients who underwent colonoscopy, observation of total colon was attained in 64 (96%). Neoplasia was found in 28 (42%) patients, including 4 patients with adenomas ≥10 mm, 1 patient with adenomas with high-grade dysplasia, and 3 patients with invasive cancer. Patients who had advanced neoplasia (adenoma ≥10 mm, adenomas with high-grade dysplasia, or invasive cancer) were likely to have a lower performance status (PS) (7/8 were PS 3) than those who did not (P=0.054). CONCLUSIONS: Clinically significant tumors were found in a considerable portion of LDLT candidates, particularly in lower PS patients. Because immunosuppressive agents after transplantation may worsen malignant tumors, colonoscopy before transplantation is recommended in patients who can tolerate the procedure.

Original languageEnglish
Pages (from-to)69-74
Number of pages6
JournalJournal of Clinical Gastroenterology
Volume43
Issue number1
DOIs
Publication statusPublished - Jan 2009

Fingerprint

Living Donors
Colonoscopy
Transplants
Liver
Liver Transplantation
Adenoma
Neoplasms
End Stage Liver Disease
Transplantation
Immunosuppressive Agents
Hepatocellular Carcinoma
Colorectal Neoplasms
Japan
Colon
Observation

Keywords

  • Colonoscopy
  • Living-donor liver transplantation
  • Neoplasia

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Feasibility and findings of colonoscopy for living-donor liver transplant candidates. / Ishikawa, Shin; Kato, Jun; Kuriyama, Motoaki; Takemoto, Koji; Uraoka, Toshio; Takaki, Akinobu; Yagi, Takahito; Sakaguchi, Kohsaku.

In: Journal of Clinical Gastroenterology, Vol. 43, No. 1, 01.2009, p. 69-74.

Research output: Contribution to journalArticle

Ishikawa, Shin ; Kato, Jun ; Kuriyama, Motoaki ; Takemoto, Koji ; Uraoka, Toshio ; Takaki, Akinobu ; Yagi, Takahito ; Sakaguchi, Kohsaku. / Feasibility and findings of colonoscopy for living-donor liver transplant candidates. In: Journal of Clinical Gastroenterology. 2009 ; Vol. 43, No. 1. pp. 69-74.
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N2 - BACKGROUND AND AIMS: Living-donor liver transplantation (LDLT) has been widely performed in patients with end-stage liver disease and hepatocellular carcinoma in Japan. Although extrahepatic cancer survey for LDLT candidates is absolutely required, few reports have indicated the optimal surveillance method for colorectal cancer. The aim of this study is to investigate the feasibility and findings of colonoscopy before LDLT. PATIENTS AND METHODS: From January 2004 to August 2006, we prospectively enrolled all of the scheduled LDLT candidates of our hospital for pretransplant colonoscopy examination. RESULTS: A total of 81 patients were enrolled for colonoscopy. Of these patients, 67 (83%) could actually undergo colonoscopy. Patients who could not undergo colonoscopy exhibited more impaired liver function than those who could (median Model End-Stage Liver Disease score; 25.5 vs. 14.5, P=0.0003). Among patients who underwent colonoscopy, observation of total colon was attained in 64 (96%). Neoplasia was found in 28 (42%) patients, including 4 patients with adenomas ≥10 mm, 1 patient with adenomas with high-grade dysplasia, and 3 patients with invasive cancer. Patients who had advanced neoplasia (adenoma ≥10 mm, adenomas with high-grade dysplasia, or invasive cancer) were likely to have a lower performance status (PS) (7/8 were PS 3) than those who did not (P=0.054). CONCLUSIONS: Clinically significant tumors were found in a considerable portion of LDLT candidates, particularly in lower PS patients. Because immunosuppressive agents after transplantation may worsen malignant tumors, colonoscopy before transplantation is recommended in patients who can tolerate the procedure.

AB - BACKGROUND AND AIMS: Living-donor liver transplantation (LDLT) has been widely performed in patients with end-stage liver disease and hepatocellular carcinoma in Japan. Although extrahepatic cancer survey for LDLT candidates is absolutely required, few reports have indicated the optimal surveillance method for colorectal cancer. The aim of this study is to investigate the feasibility and findings of colonoscopy before LDLT. PATIENTS AND METHODS: From January 2004 to August 2006, we prospectively enrolled all of the scheduled LDLT candidates of our hospital for pretransplant colonoscopy examination. RESULTS: A total of 81 patients were enrolled for colonoscopy. Of these patients, 67 (83%) could actually undergo colonoscopy. Patients who could not undergo colonoscopy exhibited more impaired liver function than those who could (median Model End-Stage Liver Disease score; 25.5 vs. 14.5, P=0.0003). Among patients who underwent colonoscopy, observation of total colon was attained in 64 (96%). Neoplasia was found in 28 (42%) patients, including 4 patients with adenomas ≥10 mm, 1 patient with adenomas with high-grade dysplasia, and 3 patients with invasive cancer. Patients who had advanced neoplasia (adenoma ≥10 mm, adenomas with high-grade dysplasia, or invasive cancer) were likely to have a lower performance status (PS) (7/8 were PS 3) than those who did not (P=0.054). CONCLUSIONS: Clinically significant tumors were found in a considerable portion of LDLT candidates, particularly in lower PS patients. Because immunosuppressive agents after transplantation may worsen malignant tumors, colonoscopy before transplantation is recommended in patients who can tolerate the procedure.

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