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Addition of a total pancreatectomy and pancreas transplantation in a liver transplant recipient with intraductal papillary mucinous neoplasm of the pancreas
Author(s) -
Fridell Jonathan A,
Vianna Rodrigo,
Mangus Richard S,
Kazimi Marwan,
Hollinger Edward,
Joseph Tector A
Publication year - 2008
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2008.00863.x
Subject(s) - medicine , pancreas transplantation , pancreas , immunosuppression , pancreatectomy , intraductal papillary mucinous neoplasm , transplantation , cirrhosis , liver transplantation , hepatocellular carcinoma , diabetes mellitus , population , general surgery , surgery , gastroenterology , kidney transplantation , endocrinology , environmental health
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. Conclusion: 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.