Post-liver transplant Crohn's disease: graft tolerance but not self-tolerance?

Digestive Diseases and Sciences
Alnoor RamjiEric M Yoshida

Abstract

Inflammatory bowel disease (IBD) rarely occurs de novo after liver transplantation, and when it does usually presents as ulcerative colitis in patients transplanted for primary sclerosing cholangitis. We present two patients who developed de novo Crohn's colitis two and three years after liver transplant for primary biliary cirrhosis (PBC) and chronic hepatitis B infection, respectively. Both were on maintenance immunosuppression with a calcineurin inhibitor and azathioprine with no evidence of allograft rejection. Investigations for enteric and opportunistic infection were negative. In the nontransplant setting, the development of IBD is likely multifactorial with an immune origin. In our cases, the immunosuppression was titrated to minimal levels when IBD developed. Clearly, although a significant degree of allograft tolerance can occur, autoimmune diseases can still develop elsewhere, suggesting selective immune tolerance.

Citations

Dec 17, 2008·Digestive Diseases and Sciences·Sharad SharmaNicolas Jabbour
May 10, 2013·Inflammatory Bowel Diseases·Sansrita NepalBo Shen
Apr 3, 2004·Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology·Bettina HarmsR Mark Beattie
Jul 31, 2013·The American Journal of Gastroenterology·Siddharth SinghJayant A Talwalkar
Oct 6, 2012·Journal of Clinical Pathology·Stephen LeeM Priyanthi Kumarasinghe
Dec 16, 2006·Digestive Diseases and Sciences·Kevin HalseyDarren C Schwartz
Jun 23, 2006·The American Journal of Gastroenterology·Marcus A WörnsStephan Kanzler
Dec 3, 2010·Journal of Crohn's & Colitis·Konstantinos H KatsanosUNKNOWN Northwest Greece IBD Study Group
Sep 20, 2020·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Giorgos Bamias, Fabio Cominelli
Jun 15, 2021·American Journal of Clinical Pathology·Jiayun M FangMaria Westerhoff
Dec 11, 2007·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Katherine FreemanBo Shen

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