Kießler M, Friess H, Assfalg V. Prevalence and risk of progression of pancreatic cystic lesions in immunosuppressed patients: A systematic review and meta-analysis. World J Transplant 2025; 15(2): 98055 [DOI: 10.5500/wjt.v15.i2.98055]
Corresponding Author of This Article
Maximilian Kießler, MD, Doctor, Department of Surgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Straße 22, München 81675, Germany. maximilian.kiessler@tum.de
Research Domain of This Article
Transplantation
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Jun 18, 2025; 15(2): 98055 Published online Jun 18, 2025. doi: 10.5500/wjt.v15.i2.98055
Prevalence and risk of progression of pancreatic cystic lesions in immunosuppressed patients: A systematic review and meta-analysis
Maximilian Kießler, Helmut Friess, Volker Assfalg
Maximilian Kießler, Volker Assfalg, Department of Surgery, Klinikum Rechts der Isar, Technische Universität München, München 81675, Germany
Helmut Friess, Department of Surgery, Technische Universität München, München 81675, Germany
Author contributions: Kießler M performed the systematic review and meta-analysis and wrote the manuscript; Assfalg V had the idea for the study and supervised the data collection and analysis; Friess H supervised the study and made essential notes on the manuscript.
Conflict-of-interest statement: The authors declare no conflict-of-interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maximilian Kießler, MD, Doctor, Department of Surgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Straße 22, München 81675, Germany. maximilian.kiessler@tum.de
Received: June 16, 2024 Revised: November 10, 2024 Accepted: January 23, 2025 Published online: June 18, 2025 Processing time: 249 Days and 18.2 Hours
Abstract
BACKGROUND
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.
AIM
To evaluate the prevalence of pancreatic cystic lesions and the risk of cyst progression in immunosuppressed patients.
METHODS
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.
RESULTS
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, P = 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), P = 0.61].
CONCLUSION
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.
Core Tip: Immunosuppression does not increase the prevalence of pancreatic cystic lesions, nor does it increase the risk cyst progression in terms of size and development and resection criteria or worrisome features.
