Natural history and management of IPMN in solid organ transplant patients: is it any different?

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2025-04-14 DOI:10.1016/j.hpb.2025.04.004

Melissa E Chen, Chirag S Desai

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引用次数: 0

Abstract

Background: Intraductal papillary mucinous neoplasms (IPMNs) are premalignant lesions with established surveillance and surgical resection guidelines. This systematic review aims to provide evidence-based guidance for managing IPMNs in transplant patients.

Methods: A search of MEDLINE, Embase, and Scopus identified studies published between January 1, 2004, and July 31, 2024, describing transplant candidates or recipients with IPMNs. Covidence software was used to screen and synthesize articles. Data were reviewed to determine whether IPMNs should preclude transplant, delay listing, require different surveillance, necessitate adjusted immunosuppression, or affect surgical complexity or cancer conversion rates.

Results: Seventeen studies involving 7023 transplant patients, including 339 with suspected or confirmed IPMNs (4.82 %), were analyzed. No evidence suggested IPMNs should preclude transplant candidacy or delay listing. IPMN surveillance guidelines for transplant patients should align with those for non-transplant patients. Transplant recipients did not experience higher rates of IPMN conversion to pancreatic cancer, indicating no need to modify immunosuppression.

Conclusion: This qualitative systematic review found no evidence that the natural history or management of IPMNs differs between transplant and non-transplant patients, suggesting no need for special management in transplant populations.

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实体器官移植患者IPMN的自然病史和处理：有什么不同吗？

背景：导管内乳头状粘液瘤（IPMNs）是一种癌前病变，有明确的监测和手术切除指南。本系统综述旨在为移植患者IPMNs的管理提供循证指导。方法：检索MEDLINE， Embase和Scopus，确定2004年1月1日至2024年7月31日之间发表的描述移植候选患者或ipmn受体的研究。采用冠状病毒软件筛选合成文章。我们对数据进行了回顾，以确定IPMNs是否应该排除移植、推迟上市、需要不同的监测、需要调整免疫抑制、或影响手术复杂性或癌症转换率。结果：17项研究涉及7023例移植患者，其中339例疑似或确诊IPMNs（4.82%）。没有证据表明IPMNs应该排除移植候选或延迟上市。移植患者的IPMN监测指南应与非移植患者一致。移植受者没有经历更高的IPMN转化为胰腺癌的比率，这表明不需要修改免疫抑制。结论：本定性系统评价未发现移植和非移植患者IPMNs的自然病史或管理有差异的证据，提示移植人群不需要特殊管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).