title: Liver transplant patients have a risk of progression similar to that of sporadic patients with branch duct intraductal papillary mucinous neoplasms.
abstract: Intraductal papillary mucinous neoplasms (IPMNs) have malignant potential and can progress from low- to high-grade dysplasia to invasive adenocarcinoma. The management of patients with IPMNs is dependent on their risk of malignant progression, with surgical resection recommended for patients with branch-duct IPMN (BD-IPMN) who develop high-risk features. There is increasing evidence that liver transplant (LT) patients are at increased risk of extrahepatic malignancy. However, there are few data regarding the risk of progression of BD-IPMNs in LT recipients. The aim of this study was to determine whether LT recipients with BD-IPMNs are at higher risk of developing high-risk features than patients with BD-IPMNs who did not receive a transplant. Consecutive patients who underwent an LT with BD-IPMNs were included. Patients with BD-IPMNs with no history of immunosuppression were used as controls. Progression of the BD-IPMNs was defined as development of a high-risk feature (jaundice, dilated main pancreatic duct, mural nodule, cytology suspicious or diagnostic for malignancy, cyst diameter ≥3 cm). Twenty-three LT patients with BD-IPMN were compared with 274 control patients. The median length of follow-up was 53.7 and 24.0 months in LT and control groups, respectively. Four (17.4%) LT patients and 45 (16.4%) controls developed high-risk features (P = 0.99). In multivariate analysis, progression of BD-IPMNs was associated with age at diagnosis but not with LT. There was no statistically significant difference in the risk of developing high-risk features between the LT and the control groups.
authors.affiliation: Division of Gastroenterology and Hepatology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins Medical Institutions, Baltimore, MD; Division of Surgery, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Lennon
authors.forename: David
authors.initials: D
authors.lastname: Victor
authors.forename: Atif
authors.initials: A
authors.lastname: Zaheer
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Ostovaneh
authors.forename: Jessica
authors.initials: J
authors.lastname: Jeh
authors.forename: Joanna K
authors.initials: JK
authors.lastname: Law
authors.forename: Neda
authors.initials: N
authors.lastname: Rezaee
authors.forename: Marco Dal
authors.initials: MD
authors.lastname: Molin
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Ahn
authors.forename: Wenchuan
authors.initials: W
authors.lastname: Wu
authors.forename: Mouen A
authors.initials: MA
authors.lastname: Khashab
authors.forename: Mohit
authors.initials: M
authors.lastname: Girotra
authors.forename: Nita
authors.initials: N
authors.lastname: Ahuja
authors.forename: Martin A
authors.initials: MA
authors.lastname: Makary
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Weiss
authors.forename: Kenzo
authors.initials: K
authors.lastname: Hirose
authors.forename: Michael
authors.initials: M
authors.lastname: Goggins
authors.forename: Ralph H
authors.initials: RH
authors.lastname: Hruban
authors.forename: Andrew
authors.initials: A
authors.lastname: Cameron
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Wolfgang
authors.forename: Vikesh K
authors.initials: VK
authors.lastname: Singh
authors.forename: Ahmet
authors.initials: A
authors.lastname: Gurakar
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002471:Cell Transformation, Neoplastic; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007565:Jaundice / Q000473:pathology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010181:Pancreatic Cyst / Q000150:complications* / Q000175:diagnosis*; D010183:Pancreatic Ducts; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000175:diagnosis*; D012189:Retrospective Studies; D016896:Treatment Outcome