S80 Outcomes of Crohn's Disease in Patients After Renal Transplant
Notice bibliographique
Résumé
Background: Data regarding the course of inflammatory bowel disease (IBD) in patients after renal transplant is scarce. The aim of this study was to evaluate outcomes of Crohn’s disease (CD) in patients who have undergone renal transplant. Methods: This is a retrospective study to evaluate patients with CD and renal transplant who were followed at our institution between January 2016 and August 2022. Patients with less than 6 months follow-up after kidney transplant were excluded from the analysis. Variables analyzed were CD age of onset, Montreal classification, year of the renal transplant, CD location, history of surgical intervention related to CD, immunosuppressive drugs used post-transplant for the renal graft and for management of CD, as well as CD activity post-transplant based on clinical and endoscopic criteria. Descriptive statistics were used to analyze data. Results: A total of 93 patients were identified on initial search with 37 (62% male) meeting inclusion criteria. The mean age of patients was 58.8 years (range: 27–84 years) with a mean disease duration of 24.4 years (range: 1-70). The age at CD diagnosis was 32.4, range 9-69. Among these, 15 (55.6%) were A2, 8 (29.6%) were A3, and 4 (14.8%) were A1. The diagnosis of CD preceded the renal transplant in 33 (89.2%) of the patients. Disease location was ileal or ileo-colonic in 27 (73.0%), colonic CD in 7 (18.9%) with 1 patient (2.7%) having perianal disease with ileocolonic involvement. The location of CD was not available in 3 patients. Twenty patients (54.1%) were in clinical remission after renal transplant on chronic immunosuppressive therapy for their renal transplant, 14 (37.8%) had active disease and in 3 (8.1%) there was insufficient data. Among the 20 patients that were in clinical remission, 13 (65%) were not receiving any biologic for CD treatment. Twenty-five (67.6%) patients were on a combination of 3 post-transplant medications, typically tacrolimus, mycophenolic acid, and prednisone. Twelve (32.4%) patients were on 2 of these medications for their renal transplant. Twenty-6 (70.3%) patients had previous abdominal surgery related to CD. Eighteen (48.6%) patients were off medical therapy for their CD after renal transplant. Among those on biologic therapy for CD post renal transplant, 7 were on infliximab, 6 on vedolizumab and 3 on ustekinumab. Conclusion(s): The diagnosis of Crohn’s disease frequently preceded renal transplant. In this cohort, almost half of patients on chronic renal transplant immunosuppressive therapy did not require additional biologic agents for management of their Crohn's disease. When needed, addition of biologic therapy to patients’ post-renal immunosuppression should be considered in collaboration with the transplant team.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».