The effectiveness of vancomycin in the treatment of ulcerative colitis refractory to standard and biological therapy in liver transplant recipients

Background. Ulcerative colitis (UC) is a chronic inflammatory bowel disease of unknown etiology. Up to 80% of patients with primary sclerosing cholangitis have concomitant inflammatory bowel disease. Liver transplantation is the only curative treatment for end-stage chronic diffuse liver diseases. Treatment of UC is challenging, especially in patients who underwent liver transplantation and receive immunosuppressive therapy. Microbiota plays an important role in the pathogenesis of UC, although data on the efficacy of antibiotics in the treatment of UC are limited. We describe the effect of oral vancomycin treatment in three liver transplant recipients with UC refractory to conventional and biological therapy. All three patients achieved clinical remission and mucosal healing with oral vancomycin orally. Oral vancomycin treatment was well tolerated and resulted in sustained clinical and endoscopic remission in all three patients. Objective. To demonstrate the efficacy of oral vancomycin in the treatment of refractory ulcerative colitis in liver transplant recipients. Material and methods. The article presents observations of three liver transplant recipients with ulcerative colitis refractory to standard and biological therapy, who received vancomycin orally for 6 months. Results. Remission of refractory ulcerative colitis in liver recipients was achieved by taking vancomycin orally. Conclusion. Oral vancomycin administration in some cases lead to clinical and endoscopic remission of ulcerative colitis in recipients in whom standard and biological therapy for UC have not been effective.