UTILITY OF ENDOSCOPIC EVALUATIONS IN LIVER-TRANSPLANT CANDIDATES

Objective: The aim of this study was to determine whether endoscopic e valuation of patients referred for liver transplant evaluation contrib utes significantly to patient selection or management. Methods: Esopha gogastroduodenoscopy (EGD) was performed in transplant candidates who had not undergone this examination within a previous 6-month period, C olonoscopy (CSP) was performed if the patient was >50 yr of age or had anemia, a history of colonic pathology such as adenomatous polyps? or a history suggesting gastrointestinal tract abnormalities. Results: A total of 118 patients were studied. FGD was performed in 74 (63%) pat ients, Forty-seven patients had esophageal varices identified; in 26, this represented a new diagnosis. Other findings on EGD included porta l gastropathy (21 patients), gastric varices (seven patients!, peptic ulceration (10 patients), Barrett's esophagus (three patients), and on e case each of esophageal and gastric carcinoma. CSP was performed in 56 patients. Findings included adenomatous polyps (24 patients) and on e case of colon carcinoma. Overall, gastrointestinal pathology was dis covered in 67 (57%) of the patients undergoing endoscopic evaluation a s part of our study, Alterations in patient selection or management re sulted from 44% of the procedures performed; 42% of the patients were affected by these management changes and 2.5% of patients were removed from further transplant evaluation because of the diagnosis of malign ancy, Conclusion: Endoscopic evaluation of liver transplant candidates often identifies important gastrointestinal pathology and frequently impacts patient selection and management before OLT, (Am J Gastroenter ol 1998:93:1346-1350, (C) 1998 by Am, Cell. of Gastroenterology).