Branch duct intraductal papillary mucinous neoplasm of the pancreas in solid organ transplant recipients

Kanwar Rupinder S Gill, Mario Pelaez-Luna, Andrew Keaveny, Timothy A. Woodward, Micheal B. Wallace, Suresh T Chari, Thomas Christopher Smyrk, Naoki Takahashi, Jonathan E. Clain, Michael J. Levy, Randall K. Pearson, Bret Thomas Petersen, Mark Topazian, Santhi Swaroop Vege, Michael Kendrick, Michael B. Farnell, Massimo Raimondo

Research output: Contribution to journalArticle

17 Citations (Scopus)

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. Resulsts: T-IPMN-Br patients were younger than the NT-IPMN-Br patients (63 vs. 68years, P0.01). The median duration of follow-up for the groups was similar (29 vs. 28 months, P<NS). CIR were present in 24 (833) of T-IPMN-Br patients and 32 (1857) of NT-IPMN-Br. New CIR were noted in 6 (233) of patients in the T-IPMN-Br group during a median follow-up of 17 months (range, 3-100 months) compared with 4 (257) of patients in the NT-IPMN-Br group (PNS). 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.

Original languageEnglish (US)
Pages (from-to)1256-1261
Number of pages6
JournalAmerican Journal of Gastroenterology
Volume104
Issue number5
DOIs
StatePublished - May 2009

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Pancreatic Neoplasms
Transplants
Transplant Recipients
Cysts
Neoplasms
Organ Transplantation
Tertiary Healthcare
Tertiary Care Centers
Immunosuppression
Case-Control Studies
Transplantation

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)

Cite this

Branch duct intraductal papillary mucinous neoplasm of the pancreas in solid organ transplant recipients. / Gill, Kanwar Rupinder S; Pelaez-Luna, Mario; Keaveny, Andrew; Woodward, Timothy A.; Wallace, Micheal B.; Chari, Suresh T; Smyrk, Thomas Christopher; Takahashi, Naoki; Clain, Jonathan E.; Levy, Michael J.; Pearson, Randall K.; Petersen, Bret Thomas; Topazian, Mark; Vege, Santhi Swaroop; Kendrick, Michael; Farnell, Michael B.; Raimondo, Massimo.

In: American Journal of Gastroenterology, Vol. 104, No. 5, 05.2009, p. 1256-1261.

Research output: Contribution to journalArticle

Gill, KRS, Pelaez-Luna, M, Keaveny, A, Woodward, TA, Wallace, MB, Chari, ST, Smyrk, TC, Takahashi, N, Clain, JE, Levy, MJ, Pearson, RK, Petersen, BT, Topazian, M, Vege, SS, Kendrick, M, Farnell, MB & Raimondo, M 2009, 'Branch duct intraductal papillary mucinous neoplasm of the pancreas in solid organ transplant recipients', American Journal of Gastroenterology, vol. 104, no. 5, pp. 1256-1261. https://doi.org/10.1038/ajg.2009.62
Gill, Kanwar Rupinder S ; Pelaez-Luna, Mario ; Keaveny, Andrew ; Woodward, Timothy A. ; Wallace, Micheal B. ; Chari, Suresh T ; Smyrk, Thomas Christopher ; Takahashi, Naoki ; Clain, Jonathan E. ; Levy, Michael J. ; Pearson, Randall K. ; Petersen, Bret Thomas ; Topazian, Mark ; Vege, Santhi Swaroop ; Kendrick, Michael ; Farnell, Michael B. ; Raimondo, Massimo. / Branch duct intraductal papillary mucinous neoplasm of the pancreas in solid organ transplant recipients. In: American Journal of Gastroenterology. 2009 ; Vol. 104, No. 5. pp. 1256-1261.
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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. Resulsts: T-IPMN-Br patients were younger than the NT-IPMN-Br patients (63 vs. 68years, P0.01). The median duration of follow-up for the groups was similar (29 vs. 28 months, P<NS). CIR were present in 24 (833) of T-IPMN-Br patients and 32 (1857) of NT-IPMN-Br. New CIR were noted in 6 (233) of patients in the T-IPMN-Br group during a median follow-up of 17 months (range, 3-100 months) compared with 4 (257) of patients in the NT-IPMN-Br group (PNS). 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.",
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AU - Gill, Kanwar Rupinder S

AU - Pelaez-Luna, Mario

AU - Keaveny, Andrew

AU - Woodward, Timothy A.

AU - Wallace, Micheal B.

AU - Chari, Suresh T

AU - Smyrk, Thomas Christopher

AU - Takahashi, Naoki

AU - Clain, Jonathan E.

AU - Levy, Michael J.

AU - Pearson, Randall K.

AU - Petersen, Bret Thomas

AU - Topazian, Mark

AU - Vege, Santhi Swaroop

AU - Kendrick, Michael

AU - Farnell, Michael B.

AU - Raimondo, Massimo

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N2 - 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. Resulsts: T-IPMN-Br patients were younger than the NT-IPMN-Br patients (63 vs. 68years, P0.01). The median duration of follow-up for the groups was similar (29 vs. 28 months, P<NS). CIR were present in 24 (833) of T-IPMN-Br patients and 32 (1857) of NT-IPMN-Br. New CIR were noted in 6 (233) of patients in the T-IPMN-Br group during a median follow-up of 17 months (range, 3-100 months) compared with 4 (257) of patients in the NT-IPMN-Br group (PNS). 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.

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