[Results of colonoscopic examination in the evaluation of cirrhotic candidates for liver transplantation].
OBJECTIVE
To assess the presence of preneoplastic and neoplastic colonic lesions, as well as those related to portal hypertensive vasculopathy, and their association with liver disease in cirrhotic patients who are candidates for orthotopic liver transplantation (LT).


METHODS
Between October 2004 and December 2005, colonoscopy was performed in 92 patients who were LT candidates, aged >50 years old or aged <50 years old but with clinical indications.


RESULTS
Eighty-eight percent of the patients were > 50 years old, the mean age was 55.3 years (29-69) and 81.5% were males. The main etiology of cirrhosis was alcoholic (46.7%), and 21% were Child-Pugh class A. No abnormalities were detected in 20.7%. Polyps were discovered in 38% (35/92) of patients (adenomatous 65.2%; tubular type 86.7%). Six patients with adenomatous polyps had mild dysplasia, and one asymptomatic patient had a well-differentiated adenocarcinoma. An association was found between polyps and male sex (44% males vs 17.6% females; p=0.044) and Child-Pugh grade (63.2% Child A vs 32.9% Child B/C, p=0.016) but not with serum levels of carcinoembryonic antigen (CEA), age or etiology of liver disease. Portal hypertensive colopathy was found in 23.9%, rectal varices in 7.6% and internal or mixed hemorrhoids in 52.3%.


CONCLUSIONS
The prevalence of preneoplastic and neoplastic colonic lesions may support the use of colonoscopy in LT candidates aged >50 years-old or with a history suggesting lower gastrointestinal bleeding or other abnormalities.
Díaz-Sánchez
Antonio
A
Servicio de Aparato Digestivo, Hospital General Universitario Gregorio Marañón, Madrid, España. antoniodisan@yahoo.es
Núñez-Martínez
Oscar
O
González-Asanza
Cecilia
C
Matilla
Ana
A
Merino
Beatriz
B
Beceiro
Inmaculada
I
Ponferrada
Angel
A
Bañares
Rafael
R
Clemente
Gerardo
G
Menchén
Pedro L
PL
D000328:Adult; D000368:Aged; D003108:Colonic Diseases / Q000150:complications* / Q000175:diagnosis*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged