Restorative proctocolectomy and pouch anal anastomosis for ulcerative colitis following orthotopic liver transplantation.

This study reports on the outcome of four patients having ileal pouch anal anastomosis after orthotopic liver transplantation for sclerosing cholangitis complicating ulcerative colitis. There were no deaths on follow up. Early postoperative bleeding was a complication of colectomy or rectal excision in three, one of whom developed hepatic artery thrombosis and the overall complication rate was high. All patients are continent but one has chronic pouchitis (while receiving longterm metronidazole) and one patient has recurrent sclerosing cholangitis in the transplant.