Inflammatory bowel disease in liver transplanted patients

Table 1 Efficacy of immunosuppressive and inflammatory bowel disease treatment after liver transplant

Drug	Anti-rejection therapy	IBD therapy	IBD efficacy	Potential risks	Ref.
Prednisone	Yes	Induction	Reduction of flare up	Infectious, metabolic side effects risk of PSC recurrence	[40,48]
5-ASA	No	Induction/ Maintenance	80% reduction of flare up	Possible leukopenia with AzA	[15,16,41,48]
			53% induction of remission in recurrent IBD
			75% induction of remission in de novo IBD
AzA	Yes	Induction/ Maintenance	IBD-free survival at 5-years 88%	Leukopenia, pancreatitis, infections, malignancy	[43]
anti-TNF-alpha	No	Induction/ Maintenance	clinical improvement 78% (range 50%-100%) mucosal healing 33%-43%	Infective, autoimmune, neoplastic side effects	[47,91-97]
Tac	Yes	No	Up to 64% flare up (4-fold increased risk) risk of infectious side effects	Infective, metabolic, neoplastic side effects	[35,36,38,43,41]
CsA	Yes	UC induction	In combination with AZA up to 30% flare up risk of side effects	Infective, metabolic, neoplastic side effects	[41]
MMF	Yes	No	ND	Pancitopenia, GI side effects	[51]

LT: Liver transplant; IBD: Inflammatory bowel disease; TNF: Tumor necrosis factor; UC: Ulcerative colitis; CD: Crohn's disease; Tac: Tacrolimus; CsA: Cyclosporine; AZA: Azathioprine; MMF: Mycophenolate mofetil; ND: Not determined; GI: Gastrointestinal.