Changes in Pancreas Volume in Living Donor Liver Transplant ... : Transplantation (original) (raw)

Original Clinical Science—Liver

Brown, Cristal MD, MHS1; Ray, Callaghan2; Kuketz, Garrett BS2; Virostko, John PhD, MSCI2,3,4,5

1Department of Internal Medicine, Dell Medical School, University of Texas at Austin, Austin, TX.

2Department of Diagnostic Medicine, Dell Medical School, University of Texas at Austin, Austin, TX.

3Livestrong Cancer Institutes, Dell Medical School, University of Texas at Austin, Austin, TX.

4Department of Oncology, Dell Medical School, University of Texas at Austin, Austin, TX.

5Oden Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, TX.

Received 11 January 2024. Revision received 21 February 2024.

Accepted 29 February 2024.

C.B. participated in research design, writing the article, and data analysis. C.R. participated in the performance of the research and data analysis. G.K. participated in the research design and performance of the research. J.V. participated in the research design, performance of the research, writing the article, and data analysis.

This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (grant R03DK129979) and via the NIDDK Information Network’s New Investigator Pilot Program in Bioinformatics (grant U24DK097771). This work used Research Electronic Data Capture and Vanderbilt Clinical Translational Research Scholars resources, which are supported by UL1 TR000445 from the National Center for Advancing Translational Science/National Institutes of Health.

The authors declare no conflicts of interest.

Supplemental digital content (SDC) is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (www.transplantjournal.com).

Correspondence: John Virostko, PhD, MSCI, Department of Diagnostic Medicine, University of Texas at Austin, 210 E 24th St, Austin, TX 78712. ([email protected]).

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Abstract

Background.

Metabolic factors have a significant role in the morbidity and mortality associated with chronic liver disease. The pancreas has a central role in metabolism and metabolic risk factors but has been largely ignored in liver transplantation. Small pancreas volume has been demonstrated in pathologic conditions such as type 1 and 2 diabetes.

Methods.

This study assessed abdominal imaging before and after liver transplantation to determine if liver transplantation induces changes in pancreas volume in living donor liver transplant recipients. Our secondary outcome is to correlate pancreas volume with demographic, clinical, and outcome data. We conducted a retrospective study of pancreas volume in patients enrolled in the adult-to-adult living donor liver transplantation cohort study. Pancreas volume was manually calculated from 413 MRI or computed tomography images and correlated with imaging and clinical data.

Results.

Pancreas volume declined by an average of 24% (87.8 ± 25.2 mL to 66.8 ± 20.4 mL, P < 0.0001), regardless of liver disease etiology. Pancreas volume correlated with portal blood flow, spleen volume, and liver enzyme levels. We found a correlation between smaller pancreas volume pretransplant and longer intensive care unit (ICU) stay across all patients (P < 0.05). Individuals with an ICU stay of <2 d had a larger average pancreas volume pretransplant than those with an ICU stay of 2 d or longer (91.2 versus 82.2 mL, P < 0.05).

Conclusions.

Pancreas volume is dynamic in liver transplant recipients and may reflect altered metabolism and risk of posttransplantation complications.