Ryu Dae Gon, Liu Hongqun, Lee Samuel S, Yoon Ki Tae, Brahmania Mayur
Liver Unit, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
Can Liver J. 2025 Feb 25;8(1):39-48. doi: 10.3138/canlivj-2024-0041. eCollection 2025 Feb.
Colon cancer surveillance post liver transplantation (LT) is generally recommended. This study aimed to determine the appropriate timing for the first colonoscopy after LT and the interval for subsequent surveillance colonoscopies based on our single-centre real-world experience.
The medical records of patients who underwent LT at Pusan National University Yangsan Hospital between December 2008 and March 2024 were reviewed. Patients who underwent colonoscopy at least once after LT were analyzed. After the first post-transplant colonoscopy, subsequent colonoscopies were divided into an intensive and a nonintensive surveillance group based on a 3-year interval.
A total of 404 LT recipients with 1,076 colonoscopies were analyzed. The analysis included pre-transplant (n = 219), first post-transplant (n = 404), and subsequent colonoscopies (n = 453). Cecal intubation failure and poor bowel preparation were higher in the pre-transplant colonoscopy than the post-transplant colonoscopy (3.2% versus 0.8%, = 0.010; 13.2% versus 4.4%, < 0.001). Although high-risk polyps were resected in 17 recipients (7.8%) through pre-transplant colonoscopy, they were also discovered in 17 recipients (4.2%) at the first post-transplant colonoscopy. There were no differences in malignancy or high-risk polyp detection between recipients who underwent intensive surveillance (median interval, 22 months) after the first post-transplant colonoscopy and those who did not (median interval, 52 months; 0.6% versus 2.1%, = 0.381 and 3.7% versus 2.1%, = 0.598).
Colonoscopy prior to LT may be insufficient; therefore, the first colonoscopy after LT should be performed within 1 year. Subsequent colonoscopies should follow the general surveillance interval.
肝移植（LT）后通常建议进行结肠癌监测。本研究旨在根据我们单中心的真实世界经验，确定LT后首次结肠镜检查的合适时机以及后续监测结肠镜检查的间隔时间。
回顾了2008年12月至2024年3月在釜山国立大学梁山医院接受LT的患者的病历。分析了LT后至少进行过一次结肠镜检查的患者。在首次移植后结肠镜检查后，后续结肠镜检查根据3年间隔分为强化监测组和非强化监测组。
共分析了404例LT受者的1076次结肠镜检查。分析包括移植前（n = 219）、首次移植后（n = 404）和后续结肠镜检查（n = 453）。移植前结肠镜检查的盲肠插管失败率和肠道准备不佳率高于移植后结肠镜检查（3.2%对0.8%，P = 0.010；13.2%对4.4%，P < 0.001）。虽然通过移植前结肠镜检查在17例受者（7.8%）中切除了高危息肉，但在首次移植后结肠镜检查中也在17例受者（4.2%）中发现了高危息肉。首次移植后结肠镜检查后接受强化监测（中位间隔22个月）的受者与未接受强化监测的受者（中位间隔52个月；0.6%对2.1%，P = 0.381；3.7%对2.1%，P = 0.598）在恶性肿瘤或高危息肉检测方面没有差异。
LT前的结肠镜检查可能不够充分；因此，LT后的首次结肠镜检查应在1年内进行。后续结肠镜检查应遵循一般监测间隔。
