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• W2914893808 abstract "Introduction: Pancreatic cysts are a common incidental finding in liver transplant candidates. Immunosuppressive medications used in solid organ transplant recipients (SOTRs) increase the risk of development of malignancies. The risk of progression of pancreatic cysts in SOTRs remains unknown. The aims of this study were to establish the incidence of pancreatic cyst progression in SOTRs and to establish the relative risk of progression in SOTRs compared to controls. Methods: A systematic search was performed using PubMed, Embase, and Cochrane databases to April 21, 2017, without language or year limitations, with a medical reference librarian. Search terms were “pancreatic cyst” or “intraductal papillary mucinous neoplasm” (IPMN) and “solid organ transplant” with all associated permutations. Studies of adult SOTRs with pancreatic cysts or IPMNs followed to assess cyst progression were included for analysis. Case reports/series (≤3 patients) were excluded. A recursive search was performed of the references of included articles. The primary outcome measure was a composite outcome of new development of worrisome features defined by the Fukuoka criteria, high-risk features, consensus indication for surgical resection or malignancy. Overall incidence and relative risk was calculated using a meta-analysis with fixed and random effects models. Results: There were 120 total search results. All results were reviewed in abstract form by 2 authors (JAB & JG). Nine studies of 446 patients with pancreatic cysts who underwent solid organ transplantation met inclusion criteria, dating from 2009 to 2016. Of the 9 studies, 4 had control groups (98 cases vs. 488 controls with cysts). The overall incidence of cyst progression to the primary outcome in SOTRs was 4% via fixed & 7% via random effects models (30/446 SOTRs) in 9 studies, compared to 13.5% (66/488) in controls in 4 studies, with relative risk of 1.23 (95%CI 0.65-2.31; P=ns) in cases vs. controls (Figures 1-2). There were 2 total cases of development of pancreatic cancer (0.45%) in SOTRs and 1 in the control group (0.2%). No attributable deaths were reported.Figure: Forest Plot of Incidence of Progression to Primary Outcome in all Solid Organ Transplant Recipients.Figure: Forest Plot of Relative Risk of Progression to Primary Outcome in Studies of Solid Organ Transplant Recipients Compared to Controls.Conclusion: This is the first systematic review and meta-analysis examining risk of progression of pancreatic cysts in SOTRs. The risk of pancreatic cyst progression in SOTRs remains low with no significantly increased risk compared to controls. Presence of pancreatic cysts should not be considered a contraindication to solid organ transplantation." @default.
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• W2914893808 date "2017-10-01" @default.
• W2914893808 modified "2023-09-26" @default.
• W2914893808 title "Risk of Progression of Pancreatic Cysts in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis: 2017 Presidential Poster Award" @default.
• W2914893808 doi "https://doi.org/10.14309/00000434-201710001-00055" @default.
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