Yield of Screening Colonoscopy in Renal Transplant Candidates

AlAmeel, Turki; Bseiso, Bahaa; AlBugami, Meteb M; Al-Momen, Sami; Roth, L

doi:10.1155/2015/823835

Cited by 10 publications

(6 citation statements)

References 21 publications

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“…We found an overall adenoma detection rate of 18.1% of the patients who underwent endoscopy within the pre-transplant work-up. These results correspond to results in the literature for the general population, as well as the ESRD population [ 36 , 48 – 50 ]. The studied population of patients with ESRD is a subgroup that actually received a kidney graft.…”

Section: Discussionsupporting

confidence: 90%

Colonoscopy as Part of Pre-Transplant Work-Up in Successful Kidney Transplant Candidates: Single-Center Experience and Review of Literature

et al. 2018

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BackgroundScreening colonoscopy is not obligatory in kidney pre-transplant work-up guidelines. According to recommendations, only transplant recipients over age 50 years should be screened. The aim of this study was to characterize endoscopic findings revealed as part of pre-transplant work-up.Material/MethodsWe retrospectively reviewed pre-transplant work-up charts of 434 adult patients who received a cadaveric donor kidney transplantation (KT) from 2012 to 2015. Endoscopic findings analysis with age subgroup (<50 and ≥50) analysis were performed.ResultsOut of 434 of patients that underwent KT, 29% have had a colonoscopy. In 75.6% of those, pathologies were found. Hemorrhoids were found in 33% and polyps in 30.7% of patients. Adenoma detection rate (ADR) was 18.1% (67.5% distal predominance). Advanced ADR was 10.2% (distal predominance). Diverticulosis was found in 28.3% of patients and ulcerative colitis was found in 2.4%. In age subgroup analysis, ADR was higher in patients ≥50 years compared to those <50 years (21.6% vs. 4%; p=0.041).ConclusionsColonoscopy as part of pre-transplant work-up enables removal of precancerous lesions and management of benign findings. All candidates meeting criteria for the general population should be screened. Patients under age 50 years could also benefit from colonoscopy as part of the pre-transplant work-up. Therefore, we suggest that baseline colonoscopy should be included in pre-transplant work-up guidelines for all patients, regardless of age. However, further studies are needed to confirm this recommendation.

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Section: Discussionsupporting

confidence: 90%

Colonoscopy as Part of Pre-Transplant Work-Up in Successful Kidney Transplant Candidates: Single-Center Experience and Review of Literature

et al. 2018

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“…In our study, the prevalence of overall adenoma, advanced adenoma, and CRC among the pretransplant ESRD patients was 35.4%, 8.1%, and 0.2%, respectively. The rate of adenoma detection via colonoscopy among pretransplant ESRD patients in our study (35.4%) is higher than most reported adenoma detection rates for the general population, although there are other recent reports [23][24][25][26] of higher rates of adenomatous polyps in chronic kidney disease and ESRD patients that vary from 24% to 54%. Furthermore, the risk of CRC appears higher in solid-organ transplant patients than in the general population.…”

Section: Discussioncontrasting

confidence: 86%

Untitled

Chaung

Park

et al. 2017

Exp Clin Transplant

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Objectives: Transplant centers often recommend, but not necessarily require, screening colonoscopies for people over 50 years of age in accordance with the US Preventative Services Task Force guidelines for the general population. We sought to identify risk factors affecting colonoscopy results in renal failure patients undergoing kidney transplant evaluation. Materials and Methods: We retrospectively examined patients undergoing kidney transplant evaluation from 2009 to 2012 (n = 469 patients). Comparisons were made between colonoscopy reports categorized as normal (no finding or hyperplastic polyp) or abnormal (adenomatous polyp or carcinoma). Results: Of 469 patients who met the study criteria, 303 (64.6%) had normal colonoscopies and 166 (35.4%) had abnormal colonoscopies. Logistic regression analysis showed that male sex (odds ratio = 2.09; 95% confidence interval, 1.37-3.20; P = .001) and increasing age (odds ratio = 1.04; 95% confidence interval, 1.01-1.08; P = .019) were more likely to correspond to abnormal findings. Those with dialysis vintage (length of time on dialysis) up to 3 years (odds ratio = 2.10; 95% confidence interval, 1.09-4.06; P = .027) and hypertension as the cause of renal failure (odds ratio = 1.79; 95% confidence interval, 1.05-2.87; P = .002) had more abnormal findings. No differences in length of evaluation, rate of being listed for transplant, and rate of transplant were shown. Conclusions:The overall rate of adenomatous findings on colonoscopy was higher among patients with pretransplant end-stage renal disease than in the general population, as shown in other studies. Age, sex, dialysis vintage up to 3 years, and hypertensive renal failure were associated with adenomatous polyps of the colon in this study population. Because adenomatous polyp rates are high in patients with chronic kidney disease who are undergoing transplant evaluation and colonoscopic findings do not appear to delay transplant evaluations or listing rates, screening colonoscopies should be encouraged.

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“…This study about the results of screening colonoscopy in a cohort of 169 renal transplant candidates over 50 years old showed a prevalence of colorectal polyps of 24%, 4 advanced adenomas, and 1 adenocarcinoma. The authors conclude that colorectal cancer screening is indicated in renal transplant candidates over 50 years old and that the choice of the screening test should be individualized based on patient's preference and risk benefit ratio [ 1 ].…”

mentioning

confidence: 99%