pISSN 2671-8790 eISSN 2671-8804

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Korean J Transplant 2022; 36(3): 197-202

Published online September 30, 2022

https://doi.org/10.4285/kjt.22.0020

© The Korean Society for Transplantation

Prevalence and clinical significance of pancreatic cystic lesions in immunosuppressed patients following solid organ transplantation

Sehyeon Yu1,* , Yoo Jin Choi2,* , Hye-Sung Jo2 , Pyoung-Jae Park3 , Dong-Sik Kim2 , Young-Dong Yu2

1Department of Surgery, Korea University College of Medicine, Seoul, Korea
2Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea
3Division of Transplant and Vascular Surgery, Department of Surgery, Korea University College of Medicine, Seoul, Korea

Correspondence to: Young-Dong Yu
Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea
Tel: +82-2-920-6402
Fax: +82-2-928-1631
E-mail: hust1351@naver.com

Pyoung-Jae Park
Division of Transplant and Vascular Surgery, Department of Surgery, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea
Tel: +82-2-2626-3069
Fax: +82-2-2626-1148
E-mail: pyoungjae@hanmail.net
*These authors contributed equally to this work.

Received: April 11, 2022; Revised: May 23, 2022; Accepted: May 24, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Pancreatic cystic lesions (PCLs) are occasionally found in solid organ transplant (SOT) recipients. In such recipients, the risk of cancer is increased due to immunosuppressive therapy. This study investigated the prevalence of PCLs and described their clinical course in immunosuppressed patients following SOT.
Methods: The presence of PCLs in a retrospective cohort of 805 consecutive SOT recipients from 2009 to 2019 was examined. The characteristics of PCLs were compared using initial and follow-up imaging, where available. These results were compared to an age- and sex-matched immunocompetent control group monitored for at least 12 months.
Results: PCLs were present in 15 of 805 SOT patients (seven liver and eight kidney transplantations). The median diameter of the largest lesion was 20 mm (range, 0.2–60 mm) and 60% of lesions were benign. During follow-up imaging, the cyst size remained stable in 46.7%, increased in 13.3%, and decreased in 40.0% of the SOT group. Significantly more of the SOT patients showed PCL size reductions (P=0.007). Among SOT patients diagnosed with intraductal papillary mucinous neoplasms (6/15), worrisome features were noted in one patient at the time of cyst diagnosis. Differences in the development of worrisome features between the study and control groups were not statistically significant.
Conclusions: The malignant transformation of PCLs in SOT recipients is rare and most such PCLs can be managed conservatively. The presence of a PCL should therefore not affect transplant eligibility.

Keywords: Pancreatic cyst, Organ transplantation, Immunosuppression therapy, Pancreatic neoplasms

HIGHLIGHTS
  • In solid organ transplantation patients, the risk of cancer is increased due to immunosuppressive therapy.

  • When comparing pancreatic cystic lesions between a solid organ transplantation group and a normal control group, there was no significant difference in the development of worrisome features.

  • The presence of a pancreatic cystic lesion should not affect transplant eligibility.