title: Addition of a total pancreatectomy and pancreas transplantation in a liver transplant recipient with intraductal papillary mucinous neoplasm of the pancreas.
abstract: BACKGROUND
  Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are increasingly recognized in clinical practice. There are no published data suggesting a management approach for the potential organ transplant recipient with the incidental finding of this pre-malignant lesion.
  
  
  METHODS
  The recipient was a 65-yr-old man with hepatocellular carcinoma in a background of Laennec's cirrhosis. During evaluation for transplant, he was found to have diffuse IPMN. This patient underwent liver transplantation with a planned simultaneous total native pancreatectomy and pancreas transplant from the same donor.
  
  
  RESULTS
  The patient has had normal liver function and has been free of diabetes and exocrine insufficiency at 18 months post-transplant.
  
  
  CONCLUSIONS
  IPMN in the potential transplant recipient should be managed more aggressively than in the general population because these patients will be committed to life-long immunosuppression. If a total pancreatectomy is contemplated, this is a unique opportunity to replace the pancreas with an allograft at the time of transplantation.
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA. jfridell@iupui.edu
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Fridell
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Vianna
authors.forename: Richard S
authors.initials: RS
authors.lastname: Mangus
authors.forename: Marwan
authors.initials: M
authors.lastname: Kazimi
authors.forename: Edward
authors.initials: E
authors.lastname: Hollinger
authors.forename: A
authors.initials: A
authors.lastname: Joseph Tector
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000601:surgery*; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000601:surgery*; D002291:Carcinoma, Papillary / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D016035:Pancreas Transplantation / Q000379:methods*; D010180:Pancreatectomy