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The risk of microscopic colitis in solid-organ transplantation patients: a population-based study

Gilaad G Kaplan1, Sansira Seminowich, Jennifer Williams

  • 1Division of Gastroenterology, Gastrointestinal Research Group, Southern Alberta Transplant Program, Department of Pathology, University of Calgary, Calgary, Alberta, Canada.

Transplantation
|January 15, 2008
PubMed
Abstract

Insights

Solid-organ transplant recipients have a significantly increased risk of developing microscopic colitis (MC). Physicians should consider MC in transplant patients experiencing chronic diarrhea, as early diagnosis and treatment are effective.

Area of Science:

  • Gastroenterology
  • Transplant Medicine
  • Immunology

Background:

  • Microscopic colitis (MC) is rarely recognized as a complication post-transplantation, potentially due to immunosuppressant use.
  • This study aimed to investigate the risk of MC development following solid-organ transplantation.

Purpose of the Study:

  • To determine the incidence and prevalence of microscopic colitis in solid-organ transplant recipients.
  • To assess the standardized incidence ratio (SIR) of MC in this population compared to the general population.

Main Methods:

  • A population-based cohort study utilized pathology and transplantation databases to identify MC cases post-kidney, kidney-pancreas, or liver transplantation.
  • Calculated annual incidence, point prevalence, and SIR with 95% confidence intervals for MC in transplant patients.

Main Results:

  • Seven cases (0.9%) of MC were diagnosed in kidney, kidney-pancreas, and liver transplant recipients.
  • The point prevalence was 8.8 per 1000 recipients, with an annual incidence rate of 5.0 per 1000 person-years.
  • The SIR for MC post-transplantation was 50.5, indicating a substantially higher risk; all diagnosed patients responded to MC-specific therapy.

Conclusions:

  • Solid-organ transplant recipients exhibit a significantly elevated risk of developing microscopic colitis.
  • Physicians should maintain a low threshold for investigating MC in transplant patients presenting with chronic diarrhea.
  • Prompt diagnosis and MC-specific therapy are effective in this patient population.

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