{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:50:24Z","timestamp":1792651824502,"version":"4.5.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2020,1,16]],"date-time":"2020-01-16T00:00:00Z","timestamp":1579132800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The impact of inflammatory bowel disease (IBD) activity on long-term outcomes after liver transplantation (LT) for primary sclerosing cholangitis (PSC) is unknown. We examined the impact of post-LT IBD activity on clinically significant outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>One hundred twelve patients undergoing LT for PSC from 2 centers were studied for a median of 7 years. Patients were divided into 3 groups according to their IBD activity after LT: no IBD, mild IBD, and moderate to severe IBD. Patients were classified as having moderate to severe IBD if they met at least 1 of 3 criteria: (i) Mayo 2 or 3 colitis or Simple Endoscopic Score\u2013Crohn\u2019s Disease \u22657 on endoscopy; (ii) acute flare of IBD necessitating steroid rescue therapy; or (iii) post-LT colectomy for medically refractory IBD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Moderate to severe IBD at any time post-transplant was associated with a higher risk of Clostridium difficile infection (27% vs 8% mild IBD vs 8% no IBD; P = 0.02), colorectal cancer\/high-grade dysplasia (21% vs 3% both groups; P = 0.004), post-LT colectomy (33% vs 3% vs 0%) and rPSC (64% vs 18% vs 20%; P &amp;lt; 0.001). Multivariate analysis revealed that moderate to severe IBD increased the risk of both rPSC (relative risk [RR], 8.80; 95% confidence interval [CI], 2.81\u201327.59; P &amp;lt; 0.001) and colorectal cancer\/high-grade dysplasia (RR, 10.45; 95% CI, 3.55\u201322.74; P &amp;lt; 0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Moderate to severe IBD at any time post-LT is associated with a higher risk of rPSC and colorectal neoplasia compared with mild IBD and no IBD. Patients with no IBD and mild IBD have similar post-LT outcomes. Future prospective studies are needed to determine if more intensive treatment of moderate to severe IBD improves long-term outcomes in patients undergoing LT for PSC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ibd\/izz325","type":"journal-article","created":{"date-parts":[[2020,1,16]],"date-time":"2020-01-16T14:44:30Z","timestamp":1579185870000},"page":"1901-1908","source":"Crossref","is-referenced-by-count":45,"title":["Activity of Inflammatory Bowel Disease After Liver Transplantation for Primary Sclerosing Cholangitis Predicts Poorer Clinical Outcomes"],"prefix":"10.1093","volume":"26","author":[{"given":"Matthew","family":"Peverelle","sequence":"first","affiliation":[{"name":"Liver Transplant Unit, Heidelberg, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarang","family":"Paleri","sequence":"additional","affiliation":[{"name":"Liver Transplant Unit, Heidelberg, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jed","family":"Hughes","sequence":"additional","affiliation":[{"name":"Liver Transplant Unit, Heidelberg, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"De Cruz","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Austin Health, Heidelberg, Victoria, Australia"},{"name":"Department of Medicine, University of Melbourne, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul J","family":"Gow","sequence":"additional","affiliation":[{"name":"Liver Transplant Unit, Heidelberg, Victoria, Australia"},{"name":"Department of Medicine, University of Melbourne, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,1,16]]},"reference":[{"key":"2020120619070822800_CIT0001","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1034\/j.1600-0676.2000.020002097.x","article-title":"Liver transplantation for primary sclerosing cholangitis","volume":"20","author":"Gow","year":"2000","journal-title":"Liver."},{"key":"2020120619070822800_CIT0002","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1053\/jlts.2003.50169","article-title":"Liver transplantation for primary sclerosing cholangitis in the Nordic countries: outcome after acceptance to the waiting list","volume":"9","author":"Brandsaeter","year":"2003","journal-title":"Liver Transpl."},{"key":"2020120619070822800_CIT0003","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1080\/003655299750025930","article-title":"Liver transplantation in the Nordic countries, 1982-1998: changes of indications and improving 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