Su1481 Cystic Lesions of the Pancreas in Solid Organ Transplant Patients

Mendoza, Mardeli Saire; Lu, Jonathan; Therapondos, George; Rivera, Ramon E.; Bzowej, Natalie

doi:10.1016/s0016-5085(15)31752-2

Cited by 2 publications

(5 citation statements)

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“…1). 9,22–32 Among the 12 studies, all were retrospective cohort studies, of which 3 were case-control studies. Study locations included Australia (n = 1), Europe (n = 3), and the United States (n = 8).…”

Section: Resultsmentioning

confidence: 99%

“…Scores for methodological quality assessment are shown in Table 2. Five studies were adjudged as low quality, 23,25,30–32 6 as moderate quality, 9,22,24,27–29 and 1 as high quality 26 . Among 12 studies, all were retrospective and single-centered.…”

Section: Resultsmentioning

confidence: 99%

“…3). 22 6 Moderate Coletti et al, 2014 31 3 L o w Lennon et al, 2014 26 8 H i g h Ngamruengphong et al, 2014 24 4 L o w Saire Mendoza et al, 2015 30 4 L o w Ngamruengphong et al, 2015 24 7 Moderate Trikudanathan et al, 2015 32 4 L o w Dorfman et al, 2016 9 6 Moderate Macinga et al, 2016 25 4 L o w Liu et al, 2017 28 7 Moderate Vidhyarkorn et al, 2017 27 6 Moderate…”

Section: Pooled Proportions Of Pcl's Progression To Malignancy and De...mentioning

confidence: 99%

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The Natural History of Pancreatic Cystic Lesions in Liver Transplant Recipients

et al. 2022

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ObjectivesThe management of incidentally discovered pancreatic cystic lesions (PCLs) with surveillance or resection often requires shared decision-making. Patients with cirrhosis are more likely to have PCLs discovered due to increased imaging, and those undergoing liver transplantations (LTs) may be at increased risk of carcinogenesis due to immunosuppressive medications. Our study aimed to characterize the outcomes and risk of malignant progression of PCLs in post-LT patients.MethodsMultiple databases were searched for studies looking at PCLs in post-LT patients from inception until February 2022. Primary outcomes were the incidence of PCLs in LT recipients and progression to malignancy. Secondary outcomes included development of worrisome features, outcomes of surgical resection for progression, and change in size.ResultsA total of 12 studies with 17,862 patients with 1411 PCLs were included. The pooled proportion of new PCL development in post-LT patients was 68% (95% confidence interval [CI], 42–86; I2 = 94%) over the follow-up of 3.7 (standard deviation, 1.5) years. The pooled progression of malignancy and worrisome features was 1% (95% CI, 0–2; I2 = 0%) and 4% (95% CI, 1–11; I2 = 89%), respectively.ConclusionsCompared with nontransplant patients, incidental PCLs do not carry a higher risk of malignancy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Pooled Proportions Of Pcl's Progression To Malignancy and De...mentioning

confidence: 99%

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The Natural History of Pancreatic Cystic Lesions in Liver Transplant Recipients

et al. 2022

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“…8 The possibility of progression of pPCLs becomes more of a concern with chronic immunosuppression. 9 Hence, this systematic review aims to assess the available data on the prevalence, common sites of these lesions, rate of growth, outcome, and management in patients who are on immunosuppression after orthotopic liver transplantation (OLT).…”

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confidence: 99%

“…Added to this is the fact that cirrhotic patients have more than 2-fold increased risk of nonhepatocellular malignancies, compared with the general population 8 . The possibility of progression of pPCLs becomes more of a concern with chronic immunosuppression 9 …”

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confidence: 99%

Current Evidence in the Management of Premalignant Cystic Lesions of the Pancreas in Patients Undergoing Liver Transplantation

Babu

Shapiro

2022

Pancreas

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Incidental premalignant pancreatic cystic lesions (pPCLs) are increasingly being detected in patients undergoing orthotopic liver transplantation (OLT). The impact of chronic immunosuppression upon pPCLs may elevate risk of progression to pancreatic cancer. This systematic review assesses prevalence, outcome, and management of pPCLs in patients undergoing OLT. Systematic literature searches were performed in accordance with Cochrane review guidelines. Data on 658 patients were identified from 13 articles. Median age was 59 years with a prevalence of 6.2%. Most studies focused on branch-duct intraductal papillary mucinous neoplasms. Average cyst size at diagnosis was 10.3 mm. Six patients (0.9%) underwent pancreatic resection, post-OLT, for suspected “worrisome features” on imaging. One death was due to pancreatic-related cancer, post-OLT. Based on the review, the authors suggest the following: (1) patients with pPCLs undergoing OLT, without “worrisome features,” should be followed conservatively; (2) presence of pPCLs alone should not preclude eligibility for OLT, nor should chronic immunosuppression be altered; (3) follow-up should parallel standard approach applied in immunocompetent patients, as development of “worrisome features” of cancer is rare and does not appear to be hastened by immunosuppression; (4) resection is recommended for surgically fit patients without portal hypertension that develop “worrisome features.”

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Su1481 Cystic Lesions of the Pancreas in Solid Organ Transplant Patients

Cited by 2 publications

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The Natural History of Pancreatic Cystic Lesions in Liver Transplant Recipients

The Natural History of Pancreatic Cystic Lesions in Liver Transplant Recipients

Current Evidence in the Management of Premalignant Cystic Lesions of the Pancreas in Patients Undergoing Liver Transplantation

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