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Published on: November 7, 2020
Long-term results of celiac disease patients who underwent liver transplantation
Caner Altun1, Osman Saglam2, Muhammed Furkan Keser3
1Department of Internal Medicine, Inonu University School of Medicine, Malatya, Turkiye.
Insights
Long-term liver transplantation (LT) outcomes for celiac disease (CD) patients show good survival but high rates of biliary complications. Post-transplant, patients experienced improved BMI and reduced anti-tissue transglutaminase levels.
Area of Science:
- Hepatology
- Gastroenterology
- Transplantation Medicine
Background:
- Celiac disease (CD) management can involve liver transplantation (LT) in rare cases.
- Limited data exists on long-term outcomes following LT in CD patients.
Purpose of the Study:
- To report the long-term outcomes of patients with celiac disease who underwent liver transplantation.
- To analyze survival rates, complications, and serological markers post-LT.
Main Methods:
- Single-center, retrospective study of 28 celiac disease patients undergoing LT.
- Diagnosis of CD confirmed by antibody testing and/or duodenal biopsy.
- Follow-up included survival rates, complication assessment, BMI, and anti-tissue transglutaminase (anti-TTG) levels.
Main Results:
- 1-, 3-, 5-, and 10-year survival rates were 92.9%, 92.9%, 84.4%, and 75%, respectively.
- High frequency of post-transplant biliary complications observed.
- Significant improvement in body mass index (BMI) and reduction in anti-TTG levels post-LT.
- Rejection incidence was 39.1%, and recurrence was 25%.
Conclusions:
- Liver transplantation in celiac disease patients is associated with significant long-term survival.
- Biliary complications are frequent after LT in this population.
- LT positively impacts BMI and reduces celiac-specific antibody levels.
Background And Aim:
Although there are a few studies reporting transplantation for celiac disease (CD), there are no studies reporting long-term outcomes after transplantation in CD patients. Therefore, we aimed to report the long-term outcomes of patients who underwent liver transplantation (LT) for CD in our high-volume liver transplantation center.
Materials And Methods:
Our study was a single-center, retrospective study and included 28 CD patients who underwent LT at Inonu University. CD diagnosis was made based on anti-tissue transglutaminase or anti-endomysium antibody positivity and/or duodenal biopsy results.
Results:
The 1-, 3-, 5-, and 10-year survival rates after transplantation were 92.9%, 92.9%, 84.4%, and 75%, respectively. The most striking finding in the study was the high frequency of biliary complications. Another important finding was the significant difference in body mass index (BMI) between pre-transplant and post-transplant (p<0.001). The incidence of rejection and recurrence was 39.1% and 25%, respectively. The number of patients with high anti-tissue transglutaminase (anti-TTG) levels after transplantation decreased significantly (p<0.001).
Conclusion:
Our study suggests that the frequency of post-transplant biliary complications is very high in CD patients and that LT had positive effects on BMI and anti-tissue transglutaminase levels.
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