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Preemptive appendicectomy at the time of pancreas transplantation: Is it necessary?

Lookup NU author(s): David Talbot, Professor Derek Manas, Steven White

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Abstract

© Başkent University 2019.Objectives: Pancreas transplant is a major intra-abdominal operation, and in most cases the graft is placed in the right iliac fossa. At our center, preemptive appendicectomy is performed at the time of pancreas transplant to prevent any future risk in a complex transplant patient. The aim of this study was to review all histology reports from the removed appendices. Materials and Methods: The histology reports from all incidental appendicectomies performed at pancreas transplant were reviewed. Results: Between January 2001 and June 2016, 107 pancreas transplants were performed (86 simultaneous pancreas and kidney transplants, 11 pancreas after kidney transplants, and 10 pancreas transplants alone), and 65 appendix histology reports were available from this patient group. All were preemptive appen-dicectomies as none of the patients had symptoms to suggest acute appendicitis. Of the 65 appendix histologies, 43 (66.2%) were reported as normal. Twenty specimens (30.8%) showed fibrosis consistent with previous inflammation of the appendix, and 12 specimens (18.5%) showed fecal material in the lumen (1 due to an obstructing fecalith and another 2 showing luminal distension with feces). Three specimens (4.6%) showed lymphoid hyperplasia. There were 5 (7.7 %) unexpected findings upon histology. In review of histology reports, 1 patient had a 1.1-mm carcinoid tumor in an otherwise normal appendix, 1 had an Enterobius species worm infestation, 1 had focal endometriosis, 1 had crypt abscesses suggestive of inflammatory bowel disease, 1 had a metaplastic polyp, and 1 had melanosis coli of unknown clinical significance. There were no cases of overt acute appendicitis. No patients experienced a complication as a direct result of their appendicectomy. Conclusions: A policy of routine appendicectomy at the time of pancreas transplant appears to be justified and safe.

Publication metadata

Author(s): Thakkar RG, Kanwar A, Singh A, Hawche G, Talbot D, Wilson C, Manas DM, White SA

Publication type: Article

Publication status: Published

Journal: Experimental and Clinical Transplantation

Year: 2019

Volume: 17

Issue: 6

Pages: 792-795

Print publication date: 01/12/2019

Online publication date: 01/10/2019

Acceptance date: 02/04/2016

ISSN (print): 1304-0855

ISSN (electronic): 2146-8427

Publisher: Baskent University

URL: https://doi.org/10.6002/ect.2019.0186

DOI: 10.6002/ect.2019.0186

PubMed id: 31580234

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