Abstract | BACKGROUND: METHODS: Between 1993 and 2009, 10 FAP patients required MMVTx. Nine were adults and one was a child, with a female:male ratio of 1:1. RESULTS: Short gut with duodenal adenomatosis and extensive desmoid tumors with pancreaticoduodenal involvement dictated need for MMVTx. SPPD was technically feasible in four recipients, and conventional evisceration including splenectomy was performed in remaining six recipients. With an overall cumulative survival of 90% at 1 year and 77% at 10 years, all SPPD recipients were alive with no single example of posttransplant lymphoproliferative disorder, graft-versus-host disease, or chronic rejection. However, SPPD was associated with an increase (P>0.3) in total ischemia time, operative time, and packed red blood cells requirement but with shorter (P=0.6) length of hospital stay. With a mean follow-up of 50±45 months (range 18-128 months), none of the 10 recipients experienced intraabdominal desmoid tumor recurrence or developed de novo visceral allograft neoplasm. CONCLUSION: MMVTx is a valuable therapeutic option for FAP patients who are in need for visceral transplantation with pathologic involvement of the pancreaticoduodenal complex. SPPD is technically feasible, and efforts should always be made to preserve native spleen because of the reported herein therapeutic advantages.
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Authors | Ruy J Cruz Jr, Guilherme Costa, Geoffrey J Bond, Kyle Soltys, Erin Rubin, Abhinav Humar, Kareem M Abu-Elmagd |
Journal | Transplantation
(Transplantation)
Vol. 91
Issue 12
Pg. 1417-23
(Jun 27 2011)
ISSN: 1534-6080 [Electronic] United States |
PMID | 21512435
(Publication Type: Journal Article)
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Topics |
- Adenomatous Polyposis Coli
(therapy)
- Adolescent
- Child
- Female
- Gardner Syndrome
(therapy)
- Gastrointestinal Tract
(pathology)
- Humans
- Infant
- Intestines
(transplantation)
- Male
- Organ Transplantation
(methods)
- Pancreas Transplantation
(methods)
- Pancreaticoduodenectomy
(methods)
- Spleen
(pathology)
- Stomach
(transplantation)
- Transplantation, Homologous
- Treatment Outcome
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