Inflammatory bowel disease (IBD) can occur before or, despite corticoids and immunosuppressive treatment, after transplantation. We collected characteristics of cases of IBD in renal transplant recipients in order to determine factors associated with flare-up of IBD after transplantation.

This is a retrospective multicenter study including 12 French transplant centers. We included all renal transplanted recipients with IBD before or after transplantation separated into 3 groups: IBD before transplantation without recurrence (no recurrent IBD), IBD before transplantation with recurrence post-transplantation (recurrent IBD) and IBD developed after transplantation without IBD before transplantation (de novo IBD). Demographic characteristics, history of auto-immune disease (AID), IBD evolution before and after transplantation, CMV infection and immunosuppressive treatment were recorded.

We included 40 patients (no recurrent IBD= 17; recurrent IBD =11 and de novo IBD=12). All but one patient received an induction therapy (19 polyclonal antibodies and 20 anti-IL2R). Mean age at transplantation for all patients was 40.6±12,7 years with 26% of men. The median delay of flare-up after transplantation was 17 (1-167) months in the recurrent IBD group and 91 (3-139) months in the de novo IBD group. CMV infection was significantly more frequent in patients who recurred (4/11) compared to patients who did not reccur (1/17). We did not observe any correlation between pre-existing AID or the immunosuppressive treatment and IBD before or after transplantation.

We report the most extensive cohort of IBD in renal transplant recipients. CMV infection may trigger recurrence of IBD after transplantation.

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