Liu K, Joshi V, van Camp L, Yang QW, Baars JE, Strasser SI, McCaughan GW, Majumdar A, Saxena P, Kaffes AJ. Prevalence and outcomes of pancreatic cystic neoplasms in liver transplant recipients. World J Gastroenterol 2017; 23(48): 8526-8532 [PMID: 29358860 DOI: 10.3748/wjg.v23.i48.8526]
Corresponding Author of This Article
Arthur J Kaffes, FRACP, MBBS, Associate Professor, Sydney Medical School, University of Sydney, AW Morrow Gastroenterology and Liver Centre, Level 9, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, NSW 2050, Australia. arthur.kaffes@sydney.edu.au
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
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Liu K, Joshi V, van Camp L, Yang QW, Baars JE, Strasser SI, McCaughan GW, Majumdar A, Saxena P, Kaffes AJ. Prevalence and outcomes of pancreatic cystic neoplasms in liver transplant recipients. World J Gastroenterol 2017; 23(48): 8526-8532 [PMID: 29358860 DOI: 10.3748/wjg.v23.i48.8526]
World J Gastroenterol. Dec 28, 2017; 23(48): 8526-8532 Published online Dec 28, 2017. doi: 10.3748/wjg.v23.i48.8526
Prevalence and outcomes of pancreatic cystic neoplasms in liver transplant recipients
Ken Liu, Vikram Joshi, Louise van Camp, Qi-Wei Yang, Judith E Baars, Simone I Strasser, Geoffrey W McCaughan, Avik Majumdar, Payal Saxena, Arthur J Kaffes
Ken Liu, Qi-Wei Yang, Simone I Strasser, Geoffrey W McCaughan, Arthur Kaffes, Sydney Medical School, The University of Sydney, NSW 2006, Australia
Ken Liu, Vikram Joshi, Judith E Baars, Simone I Strasser, Geoffrey W McCaughan, Avik Majumdar, Payal Saxena, Arthur J Kaffes, AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
Louise van Camp, Department of Radiology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
Author contributions: Liu K, Baars JE, Kaffes AJ, Saxena P, Strasser SI, Majumdar A and McCaughan GW conceived and designed the research; Liu K, Joshi V, Yang QW and van Camp L acquired the data; Liu K analyzed and interpreted the data; Liu K and van Camp L drafted the article; Liu K, van Camp L, Joshi V, Yang QW, Baars JE, Strasser SI, Majumdar A, Saxena P, McCaughan GW, Majumdar A critically revised the article; all authors read and approved the final version.
Institutional review board statement: The study was reviewed and approved by the Sydney Local Health District Human Research Ethics Committee (X15-0426 & LNR/15/RPAH/570).
Informed consent statement: As this is a large retrospective study of over 800 patients, it was not feasible to obtain informed consent. All patient data are anonymized and therefore risk of identification is low.
Conflict-of-interest statement: All authors have no conflicts of interest to declare with respect to this work.
Data sharing statement: No additional data are available
Correspondence to: Arthur J Kaffes, FRACP, MBBS, Associate Professor, Sydney Medical School, University of Sydney, AW Morrow Gastroenterology and Liver Centre, Level 9, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, NSW 2050, Australia. arthur.kaffes@sydney.edu.au
Telephone: +61-2-95162033 Fax: +61-2-95160778
Received: October 28, 2017 Peer-review started: October 30, 2017 First decision: November 21, 2017 Revised: November 27, 2017 Accepted: December 13, 2017 Article in press: December 13, 2017 Published online: December 28, 2017 Processing time: 60 Days and 0.4 Hours
ARTICLE HIGHLIGHTS
Research background
Pancreatic cystic neoplasms (PCNs) are a common incidental finding and their behaviour in liver transplantation (LT) recipients has not been well studied.
Research motivation
By studying PCNs in the LT setting, we can observe whether the immunosuppressive effects of cirrhosis (pre-LT) and anti-rejection medications (post-LT) have any impact on PCN development and progression. This would provide important information on whether current screening and surveillance for the general population can be safely applied to these patients.
Research objectives
We aimed to determine the prevalence, characteristics and clinical course of PCNs in LT recipients.
Research methods
Consecutive patients who underwent LT between January 1998 to April 2016 were retrospectively studied. Clinical and laboratory data and imaging findings on computed tomography and/or magnetic resonance cholangiopancreatography were assessed.
Research results
The prevalence of PCNs was 3.6% in our cohort of Australian LT patients which is similar to that of the general population. All PCNs were discovered incidentally and over half of PCNs developed post-LT. Only 3/31 (10%) PCNs exhibited worrisome features. All patients with intraductal papillary mucinous neoplasm (IPMN) exhibited a benign course in this study while 2/2 mucinous cystic neoplasm (MCN) (6% of PCNs) patients underwent surgical resection. No cases of pancreatic adenocarcinoma occurred in patients with pre-existing PCNs.
Research conclusions
This is the first cohort study of PCNs in Australian LT recipients. It is also the first study to describe MCNs in the LT setting. Our results suggest that current surveillance guidelines can likely be safely applied in the LT population. Our data also suggest that awareness and identification of PCNs is increasing with most being identified in the last five years of our study period.
Research perspectives
It would be important to pool experience from multiple centers to improve our knowledge of the behavior of non-IPMN PCNs in the context of immunosuppression.
