A 3-Decade Analysis of Pancreatic Adenocarcinoma after Solid Organ Transplant

Juan E. Corral, Kristopher P. Croome, Andrew P. Keaveny, Bhaumik Brahmbhatt, Paul T. Kröner, Karn Wijarnpreecha, Rohan M. Goswami, Massimo Raimondo, Michael B. Wallace, Yan Bi, Omar Y. Mousa

Research output: Contribution to journalArticlepeer-review

Abstract

Objective Solid organ transplant (SOT) recipients have moderately increased risk of pancreatic adenocarcinoma (PAC). We evaluated the incidence and survival of PAC in 2 cohorts and aimed to identify potential risk factors. Methods This study performed a retrospective cohort analysis. Cohort A was extracted from the United Network of Organ Sharing data set and cohort B from SOT recipients evaluated at 3 Mayo Clinic transplant centers. The primary outcome was age-Adjusted annual incidence of PAC. Descriptive statistics, hazard ratios, and survival rates were compared. Results Cohort A and cohort B included 617,042 and 29,472 SOT recipients, respectively. In cohort A, the annual incidence rate was 12.78 per 100,000 in kidney-pancreas, 13.34 in liver, and 21.87 in heart-lung transplant recipients. Receiving heart-lung transplant, 50 years or older, and history of cancer (in either recipient or donor) were independent factors associated with PAC. Fifty-Two patients developed PAC in cohort B. Despite earlier diagnosis (21.15% with stage I-II), survival rates were similar to those reported for sporadic (non-SOT) patients. Conclusions We report demographic and clinical risk factors for PAC after SOT, many of which were present before transplant and are common to sporadic pancreatic cancer. Despite the diagnosis at earlier stages, PAC in SOT portends a very poor survival.

Original languageEnglish (US)
Pages (from-to)54-63
Number of pages10
JournalPancreas
Volume50
Issue number1
DOIs
StatePublished - 2021

Keywords

  • BMI-body mass index
  • CI-confidence interval
  • CMP-cardiomyopathy
  • CMV-cytomegalovirus
  • COPD-chronic obstructive pulmonary disease
  • EBV-Epstein-Barr virus
  • HBV-hepatitis B virus
  • HBsAg-hepatitis B surface antigen
  • HCC-hepatocellular carcinoma
  • HCV-hepatitis C virus
  • HLA-human leukocyte antigen
  • HR-hazard ratio
  • IPMN-intraductal mucinous papillary neoplasm
  • Ig-immunoglobulin
  • MMF-mycophenolate mofetil
  • NASH-nonalcoholic steatohepatitis
  • PAC-pancreatic adenocarcinoma
  • PBC-primary biliary cirrhosis
  • PSC-primary sclerosing cholangitis
  • SD-standard deviation
  • SOT-solid organ transplantation
  • TRF-transplant recipient follow-up
  • UNOS-United Network of Organ Sharing
  • adenocarcinoma
  • incidence
  • organ transplantation
  • pancreatic cancer
  • survival

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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