title: Feasibility and findings of colonoscopy for living-donor liver transplant candidates.
abstract: OBJECTIVE
  Living-donor liver transplantation (LDLT) has been widely performed in patients with end-stage liver disease and hepatocellular carcinoma in Japan. Although extrahepatic cancer survey for LDLT candidates is absolutely required, few reports have indicated the optimal surveillance method for colorectal cancer. The aim of this study is to investigate the feasibility and findings of colonoscopy before LDLT.
  
  
  METHODS
  From January 2004 to August 2006, we prospectively enrolled all of the scheduled LDLT candidates of our hospital for pretransplant colonoscopy examination.
  
  
  RESULTS
  A total of 81 patients were enrolled for colonoscopy. Of these patients, 67 (83%) could actually undergo colonoscopy. Patients who could not undergo colonoscopy exhibited more impaired liver function than those who could (median Model End-Stage Liver Disease score; 25.5 vs. 14.5, P=0.0003). Among patients who underwent colonoscopy, observation of total colon was attained in 64 (96%). Neoplasia was found in 28 (42%) patients, including 4 patients with adenomas > or =10 mm, 1 patient with adenomas with high-grade dysplasia, and 3 patients with invasive cancer. Patients who had advanced neoplasia (adenoma > or =10 mm, adenomas with high-grade dysplasia, or invasive cancer) were likely to have a lower performance status (PS) (7/8 were PS 3) than those who did not (P=0.054).
  
  
  CONCLUSIONS
  Clinically significant tumors were found in a considerable portion of LDLT candidates, particularly in lower PS patients. Because immunosuppressive agents after transplantation may worsen malignant tumors, colonoscopy before transplantation is recommended in patients who can tolerate the procedure.
authors: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors: Shin
authors: S
authors: Ishikawa
authors: Jun
authors: J
authors: Kato
authors: Motoaki
authors: M
authors: Kuriyama
authors: Koji
authors: K
authors: Takemoto
authors: Toshio
authors: T
authors: Uraoka
authors: Akinobu
authors: A
authors: Takaki
authors: Takahito
authors: T
authors: Yagi
authors: Kohsaku
authors: K
authors: Sakaguchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008107:Liver Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D008113:Liver Neoplasms / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D055815:Young Adult