Liver transplantation may occasionally be indicated in patients with unique clinical scenarios. Little is known regarding the outcomes of patients who have had a pancreatic resection prior to, in combination with, or after
liver transplantation. A retrospective review of all patients undergoing
liver transplantation from March 1998 to March 2008 identified 17 patients who also underwent pancreatic resection. An additional literature review was performed. Five underwent pancreatic resection prior to
liver transplantation (1.7, 3.6, 3.8, 6.8, and 8.1 years), another 9 underwent pancreatic resection together with
liver transplantation, and 3 underwent pancreatic resection after
liver transplantation (2.2, 2.6, and 3.8 years). Indications for pancreatic resection included
cholangiocarcinoma (n = 6),
neuroendocrine tumor (n = 5),
pancreatic cancer (n = 2),
gastrointestinal stromal tumor (n = 1), periampullary
adenocarcinoma (n = 1), duodenal
adenomas (n = 1), and benign pancreatic mass (n = 1). Indications for
liver transplantation were metastatic
neuroendocrine tumor disease (n = 5),
primary sclerosing cholangitis (n = 5), hepatitis C virus (n = 2), metastatic
gastrointestinal stromal tumor (n = 1),
Klatskin tumor (n = 1), alcohol
cirrhosis (n = 1), alpha-1 antitrypsin deficiency (n = 1), and
chemotherapy-induced
cirrhosis (n = 1). One patient died intraoperatively, 7 patients died of
tumor recurrence, 2 patients died from transplant complications, and 7 patients are still alive. Pancreatic resection-related complications included 4
pancreatic fistulas. A literature review confirmed
liver transplantation/pancreatic resection-related complications. In conclusion,
liver transplantation and pancreatic resection remain uncommon, and a good outcome can be achieved. Recurrence of malignant disease is the main factor limiting survival, and specific morbidity may be related to pancreatic resection and
liver transplantation.