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- Title
Branch Duct Intraductal Papillary Mucinous Neoplasm of the Pancreas in Solid Organ Transplant Recipients.
- Authors
Gill, Kanwar Rupinder S.; Pelaez-Luna, Mario; Keaveny, Andrew; Woodward, Timothy A.; Wallace, Micheal B.; Chari, Suresh T.; Smyrk, Thomas C.; Takahashi, Naoki; Clain, Jonathan E.; Levy, Michael J.; Pearson, Randall K.; Petersen, Bret T.; Topazian, Mark D.; Vege, Santhi S.; Kendrick, Michael; Farnell, Michael B.; Raimondo, Massimo
- Abstract
OBJECTIVES:In immunosuppressed patients with branch duct intraductal papillary mucinous neoplasm (IPMN-Br) associated with solid organ transplantation, the risk of major pancreatic surgery has to be weighed against the risk of progression to malignancy. Recent studies show that IPMN-Br without consensus indications for resection (CIR) can be followed conservatively. We analyzed the course of IPMN-Br in patients with and without solid organ transplant.METHODS:We compared clinical and imaging data at diagnosis and follow-up of 33 IPMN-Br patients with solid organ transplant (T-IPMN-Br) with those of 57 IPMN-Br patients who did not undergo transplantation (NT-IPMN-Br). In T-IPMN-Br, we noted pre- and post-transplant imaging and cyst characteristics. This case–control study was conducted in a tertiary-care hospital for patients with IPMN-Br.RESULTS:T-IPMN-Br patients were younger than the NT-IPMN-Br patients (63 vs. 68 years, P=0.01). The median duration of follow-up for the groups was similar (29 vs. 28 months, P<NS). CIR were present in 24% (8/33) of T-IPMN-Br patients and 32% (18/57) of NT-IPMN-Br. New CIR were noted in 6% (2/33) of patients in the T-IPMN-Br group during a median follow-up of 17 months (range, 3–100 months) compared with 4% (2/57) of patients in the NT-IPMN-Br group (P=NS). Eleven patients (10 NT-IPMN-Br, 1 T-IPMN-Br) underwent surgery during follow-up. Only one NT-IPMN-Br patient was diagnosed with malignancy; all others had benign IPMN-Br.CONCLUSIONS:In participants with IPMN-Br, short-term follow-up after solid organ transplant was not associated with any significant change in cyst characteristics suggesting that incidental IPMN-Br, even in the setting of immunosuppression post-transplant, can be followed conservatively.Am J Gastroenterol 2009; 104:1256–1261; doi:10.1038/ajg.2009.62; published online 7 April 2009
- Subjects
TUMORS; PANCREATIC surgery; HEALTH risk assessment; PATIENTS; TRANSPLANTATION of organs, tissues, etc.
- Publication
American Journal of Gastroenterology (Springer Nature), 2009, Vol 104, Issue 5, p1256
- ISSN
0002-9270
- Publication type
Article
- DOI
10.1038/ajg.2009.62