Progression of Intraductal Papillary Mucinous Neoplasms of the Pancreas After Liver Transplantation
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| Natura: | Artículo Open Access |
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Wiley
2024
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| author | Bradley T. Busebee Jerry Yung‐Lun Chin Kristin Mara Brad Johnson Naoki Takahashi Shounak Majumder Kymberly D. Watt |
| author_facet | Bradley T. Busebee Jerry Yung‐Lun Chin Kristin Mara Brad Johnson Naoki Takahashi Shounak Majumder Kymberly D. Watt Bradley T. Busebee Jerry Yung‐Lun Chin Kristin Mara Brad Johnson Naoki Takahashi Shounak Majumder Kymberly D. Watt |
| collection | Wiley Open Access |
| contents | Progression of Intraductal Papillary Mucinous Neoplasms of the Pancreas After Liver Transplantation Bradley T. Busebee Jerry Yung‐Lun Chin Kristin Mara Brad Johnson Naoki Takahashi Shounak Majumder Kymberly D. Watt Clinical Transplantation ABSTRACTBackgroundIntraductal papillary mucinous neoplasms (IPMNs) are the most commonly identified pancreatic cystic neoplasms. Incidentally detected IPMNs are common among liver transplant recipients. The risk of IPMN progression to pancreatic cancer in transplant recipients and the impact of immunosuppression on the risk of malignant transformation of IPMN are unclear.MethodsIn this retrospective study of consecutive liver transplant recipients across Mayo Clinic over a 13‐year period, patients were assessed for possible IPMN by automated chart review. Pancreatic cystic lesions were characterized as suspected IPMNs based on imaging criteria. Cox proportional hazards models were used to determine the association between IPMN progression (the development of cancer or worrisome features) and clinical and immunosuppression regimen characteristics.ResultsOf 146 patients with suspected IPMNs, progression occurred in 7 patients (2 cases of IPMN‐associated cancer and 5 cases of worrisome features) over an average follow‐up of 66.6 months. Immunosuppression type, medication number, and tacrolimus trough levels were not associated with IPMN progression (p > 0.05). Combined kidney and liver transplantation (p = 0.005) and pretransplant cholangiocarcinoma (p = 0.012) were associated with IPMN progression.ConclusionIPMN progression is rare after liver transplantation even over an extended follow‐up period. The findings were notable for the absence of an association between IPMN progression and immunosuppression regimen. Larger studies are needed given the low incidence. 10.1111/ctr.15431 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/ctr.15431 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_ctr_15431 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2024 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Progression of Intraductal Papillary Mucinous Neoplasms of the Pancreas After Liver Transplantation Bradley T. Busebee Jerry Yung‐Lun Chin Kristin Mara Brad Johnson Naoki Takahashi Shounak Majumder Kymberly D. Watt Clinical Transplantation Progression of Intraductal Papillary Mucinous Neoplasms of the Pancreas After Liver Transplantation Bradley T. Busebee Jerry Yung‐Lun Chin Kristin Mara Brad Johnson Naoki Takahashi Shounak Majumder Kymberly D. Watt Clinical Transplantation ABSTRACTBackgroundIntraductal papillary mucinous neoplasms (IPMNs) are the most commonly identified pancreatic cystic neoplasms. Incidentally detected IPMNs are common among liver transplant recipients. The risk of IPMN progression to pancreatic cancer in transplant recipients and the impact of immunosuppression on the risk of malignant transformation of IPMN are unclear.MethodsIn this retrospective study of consecutive liver transplant recipients across Mayo Clinic over a 13‐year period, patients were assessed for possible IPMN by automated chart review. Pancreatic cystic lesions were characterized as suspected IPMNs based on imaging criteria. Cox proportional hazards models were used to determine the association between IPMN progression (the development of cancer or worrisome features) and clinical and immunosuppression regimen characteristics.ResultsOf 146 patients with suspected IPMNs, progression occurred in 7 patients (2 cases of IPMN‐associated cancer and 5 cases of worrisome features) over an average follow‐up of 66.6 months. Immunosuppression type, medication number, and tacrolimus trough levels were not associated with IPMN progression (p > 0.05). Combined kidney and liver transplantation (p = 0.005) and pretransplant cholangiocarcinoma (p = 0.012) were associated with IPMN progression.ConclusionIPMN progression is rare after liver transplantation even over an extended follow‐up period. The findings were notable for the absence of an association between IPMN progression and immunosuppression regimen. Larger studies are needed given the low incidence. 10.1111/ctr.15431 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Progression of Intraductal Papillary Mucinous Neoplasms of the Pancreas After Liver Transplantation |
| topic | Clinical Transplantation |
| url | https://onlinelibrary.wiley.com/doi/10.1111/ctr.15431 |