S80 Outcomes of Crohn's Disease in Patients After Renal Transplant
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".