Clinical yield of endoscopic ultrasound and endoscopic ultrasound-guided fine-needle aspiration for incidental pancreatic cysts in kidney transplant evaluation.

INTRODUCTION: For several reasons, including an elevated risk for malignancy after transplant, kidney transplant candidates undergo a thorough evaluation prior to transplantation. Further assessment of incidentally discovered pancreatic cysts on routine abdominal imaging has been assumed to be prudent, and the preferred method has been endoscopic ultrasound (EUS) and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The clinical utility of EUS/EUS-FNA with respect to transplant decision-making has not been evaluated.

MATERIALS AND METHODS: Kidney transplant candidates undergoing EUS/EUS-FNA for further evaluation of one or more pancreatic cysts were identified. The clinical yield of the EUS/EUS-FNA was determined via retrospective chart review.

RESULTS: After exclusion criteria were applied, a total of 15 cases were identified at a high-volume transplant center over a 71-month period. EUS/EUS-FNA was deemed to have a clinically relevant impact in 73.3% of cases.

CONCLUSION: Kidney transplant candidates are a unique group with respect to the need to clarify the etiology of pancreatic cysts. EUS/EUS-FNA frequently provides information that is clinically relevant to the determination of transplant status.