Pancreatic cystic lesions in liver transplant recipients


Authors: P. Mačinga 1;  D. Cupalová 2;  D. Kautznerová 2;  J. Froněk 3;  P. Trunečka 4;  J. Špičák 1;  T. Hucl 1
Authors‘ workplace: Klinika hepatogastroenterologie, Transplantcentrum, IKEM, Praha 1;  Pracoviště radiodiagnostiky a intervenční radiologie, IKEM, Praha 2;  Klinika transplantační chirurgie, Transplantcentrum, IKEM, Praha 3;  Transplantcentrum, IKEM, Praha 4
Published in: Gastroent Hepatol 2016; 70(4): 295-299
Category: Clinical and Experimental Gastroenterology: Original Article
doi: 10.14735/amgh2016295

Overview

Background:
Pancreatic cystic lesions (PCLs) are common in the general population and their prevalence increases with age. Pancreatic cystic neoplasia accounts for more than half of all pancreatic cysts. Some of them have malignant potential. Solid organ transplant recipients have an elevated cancer risk due to immunosuppression. The natural course of PCL in solid organ transplant recipients is unknown.

Aim and Methods:
The purpose of this study was to investigate the prevalence and course of incidental PCL in liver transplant recipients. We performed a retrospective analysis of imaging findings and medical records of all adult patients who underwent liver transplantation in the Institute for Clinical and Experimental Medicine in Prague between September 1996 and November 2014.

Results:
In total, 967 orthotopic liver transplantations were performed in the study period in 578 males and 389 females (mean age 51 ± 11.7). PCLs were found in 60 patients (6.2%; 26 males, 34 females; mean age 61 ± 8.9), 29 of whom had PCLs before transplantation. The median size of the detected PCLs was 10 mm (range 5–85 mm). PCLs were located in the head (35%), body (33%) and tail (15%) of the pancreas, and 17% of patients had multifocal PCL. Two or more PCLs were present in 20 patients (33%). Mean follow-up duration was 37.5 months (range 6–194). In 10 patients (17%), the size of the lesion increased (mean + 4 mm); however, progression was clinically relevant in none of the patients. Patients with PCLs were significantly older (p < 0.001), more likely to be women (p < 0.05), and were more often transplanted for primary biliary cirrhosis (p < 0.05) and α1-antitrypsin deficiency (p < 0.05). No patient died from PCL during follow-up. There was no significant difference in the survival of patients with and without PCL.

Conclusion:
PCLs are as frequent in liver transplant recipients as in the general population. Their presence was associated with higher age, female sex, and type of liver disease, but not with patient survival.

Key words:
pancreatic cyst – liver transplantation – immunosuppression

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
8. 7. 2016

Accepted:
1. 8. 2016


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