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The following is a summary of “Liver Transplantation Is Associated With a Reduced Risk of Colorectal Dysplasia in Patients With IBD and Concomitant PSC,” published in the June 2025 issue of Clinical Gastroenterology and Hepatology by Coelho-Prabhu et al. 

Primary sclerosing cholangitis (PSC) affected up to 8% of individuals with inflammatory bowel diseases (IBDs) and was related to an increased risk of colorectal neoplasia (CRN), potentially related to altered bile acid composition, with approximately 40% of PSC cases requiring liver transplantation (LT).  

Researchers conducted a retrospective study to investigate whether LT altered the risk of colorectal cancer (CRC) in adults with PSC and IBD.  

They compared colon dysplasia and cancer in patients with PSC-IBD who underwent LT vs those who did not. The primary outcome included the development of flat or visible colon cancer, low-grade dysplasia, or high-grade dysplasia. Multivariable regression models were employed to adjust for relevant confounders and assess the impact of LT on cancer or dysplasia occurrence.  

The results showed that among 979 patients with PSC-IBD, 320 had a LT, and 659 did not, with 80% diagnosed with ulcerative colitis (UC). During follow-up, 239 (24%) developed CRN. Multivariable analysis adjusting for age, sex, study site, disease duration, and IBD type found LT was linked to a reduced risk of colon dysplasia or cancer (OR, 0.66; 95% CI, 0.47–0.93). This association remained after adjusting for surveillance exam frequency, chromoendoscopy use, and the presence of endoscopically active disease. Dysplasia occurs more frequently in patients with recurrent PSC after transplantation.  

Investigators concluded that LT was linked to a decreased risk of colon cancer and dysplasia in patients with PSC and IBD. 

Source: cghjournal.org/article/S1542-3565(25)00348-9/abstract