Incidental Intraductal Papillary Mucinous Neoplasms(IPMN) of the Pancreas after Liver Transplantation

ABSTRACT

PURPOSE: The incidence and risk of malignancy are elevated in solid organ transplant recipients compared to persons in the general population. Epidemiological data reveal that the length of exposure to immunosuppressive therapy and the intensity of therapy are clearly related to the post-transplant risk of malignancy. The purpose of this study was to investigate the course of incidental intraductal papillary mucinous neoplasms (IPMN) of the pancreas after liver transplantation. METHODS: We retrospectively reviewed the medical records of 17 patients with IPMNs of the pancreas who underwent liver transplantation between January 2000 and December 2006. The mean follow-up duration was 29.6 +/- 22.8 months. RESULTS: The mean patient age was 55.2 +/- 7.2 years, and the male to female ratio was 143. All patients had branch duct type IPMNs. The lesions were located principally in the head (64.7%) and body (52.9%) of the pancreas. The mean tumor size was 13.0 +/- 6.2 mm. There were no newly developed symptoms associated with these lesions, and none of the lesions enlarged during the follow-up period. No patients underwent surgical resection of their lesions. CONCLUSION: The course of each of the incidental small IPMNs of the pancreas was uneventful for more than 2 years after liver transplantation. Therefore, patients with incidental small IPMNs of the pancreas are not immediate candidates for surgical pancreas resection. However, a longterm follow-up study with a larger sample size will be required to establish treatment guidelines in immunosuppressed patients.