Kießler Maximilian, Friess Helmut, Assfalg Volker
Department of Surgery, Klinikum Rechts der Isar, Technische Universität München, München 81675, Germany.
Department of Surgery, Technische Universität München, München 81675, Germany.
World J Transplant. 2025 Jun 18;15(2):98055. doi: 10.5500/wjt.v15.i2.98055.
Pancreatic cystic lesions are common in patients eligible for solid organ transplantation. It has been shown that the need for immunosuppression after organ transplantation increases the rate of malignancies in organ recipients. However, the impact of immunosuppression on pancreatic cystic lesions is yet unknown.
To evaluate the prevalence of pancreatic cystic lesions and the risk of cyst progression in immunosuppressed patients.
A systematic literature search was performed in relevant databases. Studies reporting either on the prevalence and/or the incidence of pancreatic cyst progression compared to a control group were implemented in the first systematic review and meta-analysis on this topic.
The prevalence of pancreatic cystic lesions was comparable with 7% (95%CI: 5%-11%) in the immunosuppressed cohort and 9% (95%CI: 5%-16%) in the control cohort. The mean cyst size increase in the immunosuppression group was 3.2 mm (range 1.0-5.2mm) compared to 3.5 mm (1.0-6.9) in the control group (standardized mean difference 0.0 mm, 95%CI: -0.3-0.2 mm, = 0.72). There was also no significant increase in the development of resection criteria or worrisome features under immunosuppression either [relative risk 1.1 (fixed effect model), 1.2 (random effects model), = 0.61].
Immunosuppression does not increase the prevalence of pancreatic cystic lesions, nor does it increase the risk of cyst progression in terms of cyst size and development of resection criteria. Therefore, pancreatic cystic lesions in transplant candidates should not be a contraindication for solid organ transplantation.
胰腺囊性病变在适合实体器官移植的患者中很常见。研究表明，器官移植后免疫抑制的需求会增加器官接受者的恶性肿瘤发生率。然而，免疫抑制对胰腺囊性病变的影响尚不清楚。
评估免疫抑制患者胰腺囊性病变的患病率及囊肿进展风险。
在相关数据库中进行系统的文献检索。在关于该主题的首次系统评价和荟萃分析中，纳入了与对照组相比报告胰腺囊肿进展患病率和/或发病率的研究。
免疫抑制队列中胰腺囊性病变的患病率为7%（95%置信区间：5%-11%），对照组为9%（95%置信区间：5%-16%），两者相当。免疫抑制组囊肿平均大小增加3.2毫米（范围1.0-5.2毫米），而对照组为3.5毫米（1.0-6.9毫米）（标准化平均差为0.0毫米，95%置信区间：-0.3-0.2毫米，P = 0.72）。在免疫抑制情况下，切除标准或可疑特征的出现也没有显著增加[相对风险1.1（固定效应模型），1.2（随机效应模型），P = 0.61]。
免疫抑制不会增加胰腺囊性病变的患病率，也不会增加囊肿大小和切除标准方面的囊肿进展风险。因此，移植候选者中的胰腺囊性病变不应成为实体器官移植的禁忌证。
