Does the inflammatory bowel disease activity alter following liver transplantation? A protocol for systematic review and meta-analysis

Document Type : Protocol

Authors

1 Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

2 Department of E-Learning, Virtual school, Shiraz University of Medical Sciences, Shiraz, Iran

3 Department of Nursing, School of Nursing and Midwifery, Student Research Committee, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran

4 Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background& Aims: Inflammatory bowel disease (IBD) is closely associated with primary sclerosing cholangitis (PSC), an uncommon chronic and progressive cholestatic liver disease. Liver transplantation (LT) is the only therapeutic strategy for PSC that may also affect the IBD course. Considering the lack of any systematic review and pursuing debate on the alterations in the clinical course of IBD after LT compared to before, we aim to systematically assess the frequencies of patients with "improved", "unchanged", or "aggravated" IBD course following LT and conduct a meta-analysis.
Methods: In this systematic review, PubMed/MEDLINE, Scopus, WoS (Clarivate Analytics), and Embase will be searched. Our search strategy (i.e. the eligibility criteria) covers prospective and retrospective observational studies evaluating the clinical course of ulcerative colitis or/and Crohn’s disease after LT, with no language limitation, published between 01.01.1970 and 30.12.2020. The selection phase, data extraction, and quality assessment will be independently implemented by two authors. In case of any disagreement between the authors, the issue will be resolved by consensus; if not resolved, the opinion of a third expert person will be asked. If there are sufficient studies, the pooled frequencies (%) of patients with "improved", "unchanged", or "exacerbated" IBD activity following LT will be calculated using random-effects meta-analysis due to the expected heterogeneity. Forest plots will show the separated and combined frequencies and their corresponding 95% CIs. Statistical heterogeneity will be evaluated by the Q-statistic test and I2 statistics. The funnel plot for assessing the potential reporting bias, Begg's and Egger's tests for meaningful results of the publication bias, and the Fill & Trim method for corrected publication bias will be used.

Keywords

References

  1. Alatab S, Sepanlou SG, Ikuta K, Vahedi H, Bisignano C, Safiri S, et al. The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet gastroenterology & hepatology. 2020;5(1):17-30.
  2. Waugh N, Cummins E, Royle P, Kandala N, Shyangdan D, Arasaradnam R, et al. Faecal calprotectin testing for differentiating amongst inflammatory and non-inflammatory bowel diseases: systematic review and economic evaluation. Health technology assessment (Winchester, England). 2013;17(55):xv-xix, 1.
  3. Palmela C, Peerani F, Castaneda D, Torres J, Itzkowitz SH. Inflammatory bowel disease and primary sclerosing cholangitis: a review of the phenotype and associated specific features. Gut and liver. 2018;12(1):17.
  4. Pollheimer MJ, Halilbasic E, Fickert P, Trauner M. Pathogenesis of primary sclerosing cholangitis. Best practice & research Clinical gastroenterology. 2011;25(6):727-39.
  5. Bowlus CL, Lim JK, Lindor KD. AGA Clinical practice update on surveillance for hepatobiliary cancers in patients with primary sclerosing cholangitis: expert review. Clinical Gastroenterology and Hepatology. 2019;17(12):2416-22.
  6. Tabibian JH, Bowlus CL. Primary sclerosing cholangitis: A review and update. Liver research. 2017;1(4):221-30.
  7. Schnitzler F, Friedrich M, Stallhofer J, Schönermarck U, Fischereder M, Habicht A, et al. Solid organ transplantation in patients with inflammatory bowel diseases (IBD): analysis of transplantation outcome and IBD activity in a large single center cohort. PLoS One. 2015;10(8).
  8. Papatheodoridis G, Hamilton M, Mistry P, Davidson B, Rolles K, Burroughs A. Ulcerative colitis has an aggressive course after orthotopic liver transplantation for primary sclerosing cholangitis. Gut. 1998;43(5):639-44.
  9. Gelley F, Miheller P, Péter A, Telkes G, Nemes B, editors. Activity of ulcerative colitis before and after liver transplantation in primary sclerosing cholangitis: the Hungarian experience. Transplantation proceedings; 2012: Elsevier.
  10. Fattahi MR, Malek-Hosseini SA, Sivandzadeh GR, Safarpour AR, Bagheri Lankarani K, Taghavi AR, et al. Clinical course of ulcerative colitis after liver transplantation in patients with concomitant primary sclerosing cholangitis and ulcerative colitis. Inflammatory bowel diseases. 2017;23(7):1160-7.
  11. Navaneethan U, Choudhary M, Venkatesh P, Lashner B, Remzi F, Shen B, et al. The effects of liver transplantation on the clinical course of colitis in ulcerative colitis patients with primary sclerosing cholangitis. Alimentary pharmacology & therapeutics. 2012;35(9):1054-63.
  12. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic reviews. 2015;4(1):1.
  13. Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, et al. Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. Journal of clinical epidemiology. 2012;65(9):934-9.
  14. Nguyen KA, Peer N, Mills EJ, Kengne AP. A meta-analysis of the metabolic syndrome prevalence in the global HIV-infected population. PloS one. 2016;11(3):e0150970.
  15. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al. Cochrane handbook for systematic reviews of interventions: John Wiley & Sons; 2019.
Iranian Journal of Colorectal Research
Volume 9, Issue 4
December 2021
Pages 144-148

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