Upper and lower gastrointestinal diseases in liver transplant candidates

The incidence and risk factors of gastrointestinal diseases in pre-liver transplant population are still a matter of debate. In a retrospective analysis, we addressed two questions: (1) Are there any lesions that occur at a higher prevalence than in the general population, and (2) are there patient characteristics that could predict their presence?

All asymptomatic patients that successfully entered the waiting list of liver transplantation were recorded. We also compared results with those obtained from a control group of non-cirrhotic patients undergoing screening for colorectal cancer. Main outcome measures were the incidence and description of upper/lower gastrointestinal findings after screening endoscopic examination.

We retrospectively evaluated from April 2004 to July 2007 a total of 80 liver transplant candidates. The most frequent pathologies were esophageal varices (71.2% of subjects), portal hypertensive gastropathy (51.2%), hemorrhoids (22.5%), and colonic polyps (18.7%). Comparison with 80 non-cirrhotic patients matched for age and sex demonstrated an increased frequency in the cirrhotic group of ulcerative colitis (6.2 vs 0%; p = 0.02) and portal hypertensive colopathy (12.5 vs 0%; p = 0.001) in non-cirrhotic of diverticulosis (10 vs 25%; p = 0.01) and hemorrhoids (22.5 vs 40%; p = 0.02). The univariate analysis showed no significant correlation between colonic polyps and patients' variables, except a mild correlation with age not confirmed at the multivariate analysis.

The incidence of some benign gastrointestinal pathologies in liver transplant candidates is different from the asymptomatic population but not that of colorectal cancer or colonic polyps.