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The Natural History of Patients With Pre-Existing and De Novo Inflammatory Bowel Disease After Solid Organ Transplantation: EITOS Study of GETECCU

2024; Oxford University Press; Volume: 31; Issue: 1 Linguagem: Inglês

10.1093/ibd/izae041

1536-4844

Iria Bastón‐Rey, Iago Rodríguez‐Lago, Ana María Téllez Luque, Berta Caballol, Carlos Soutullo, Ana Minaya‐Bravo, Argelia Castaño, Beatriz Gros, Lorena Bernal, María Teresa Diz-Lois, Horacio Alonso‐Galán, Fiorella Cañete, Beatriz Castro, Pablo Pérez‐Galindo, Carlos González‐Muñoza, Ismael El Hajra, Pilar Martínez-Montiel, Inmaculada Alonso-Abreu, Francisco Mesonero, M González-Vivó, Laia Peries, Eduardo Martín-Arranz, Carlos Abril, Ignacio Marín‐Jiménez, R Baltar, M Vicuña, N. Fernández Moreno, Eduard Brunet, Cristina Rubín de Célix, Ingrid Fajardo, Noelia Cruz, Cristina Suárez, M Rojas-Feria, A Fernández-Clotet, Marta Gimeno‐Torres, Laura Nieto‐García, Daniel de la Iglesia, Yamile Zabana, Cristina Suárez Ferrer, Manuel Barreiro‐de Acosta,

Liver Diseases and Immunity

Abstract Background Limited data are available on the outcome of inflammatory bowel disease (IBD) in patients with solid organ transplantation (SOT). We describe the natural history of pre-existing IBD and de novo IBD after SOT. Methods This was a retrospective, multicenter study that included patients with pre-existing IBD at the time of SOT and patients with de novo IBD after SOT. The primary outcome was IBD progression, defined by escalation of medical treatment, surgical therapy, or hospitalization due to refractory IBD. Risk factors were identified using multivariate Cox proportional hazard analysis. Results A total of 177 patients (106 pre-existing IBD and 71 de novo IBD) were included. Most patients with pre-existing IBD (92.5%) were in remission before SOT. During follow-up, 32% of patients with pre-existing IBD had disease progression, with a median time between SOT and IBD progression of 2.2 (interquartile range, 1.3-4.6) years. In the de novo cohort, 55% of patients had disease progression with a median time to flare of 1.9 (interquartile range, 0.8-3.9) years after diagnosis. In the pre-existing IBD cohort, active IBD at the time of SOT (hazard ratio, 1.80; 95% confidence interval, 1.14-2.84; P = .012) and the presence of extraintestinal manifestations (hazard ratio, 3.10; 95% confidence interval, 1.47-6.54; P = .003) were predictive factors for IBD progression. Conclusions One-third of patients with pre-existing IBD and about half of patients with de novo IBD have disease progression after SOT. Active IBD at the time of SOT and the presence of extraintestinal manifestations were identified as risk factors for IBD progression.