Increased risk of PTLD in lung transplant recipients with cystic fibrosis
| Autor: | Shellee A. Grim, Erin M. Lowery, William Adams, Jennifer E. Layden, Nina M. Clark, Leah Edwards |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Herpesvirus 4 Human Time Factors Cystic Fibrosis medicine.medical_treatment Population Statistics as Topic Cytomegalovirus 030230 surgery Single Center Cystic fibrosis Post-transplant lymphoproliferative disorder 03 medical and health sciences 0302 clinical medicine Postoperative Complications Risk Factors hemic and lymphatic diseases Internal medicine medicine Prevalence Lung transplantation Humans education Proportional Hazards Models education.field_of_study business.industry Hazard ratio medicine.disease Lymphoproliferative Disorders United States surgical procedures operative Pediatrics Perinatology and Child Health Cohort Immunology Female business Serostatus 030215 immunology Lung Transplantation |
| Zdroj: | Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society. 16(6) |
| ISSN: | 1873-5010 |
| Popis: | Post-transplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality following lung transplantation. Recipients with cystic fibrosis (CF) may have an increased risk of PTLD although the literature is limited to single center cohorts. Our primary aim is to examine PTLD in an adult lung transplant population by utilizing the International Society for Heart and Lung Transplantation Registry.We studied 30,598 adult recipients of lung transplants performed between 1999 and 2011. The primary outcome was development of and time to PTLD. In addition to indication for transplant, other predictors examined included Epstein-Barr virus (EBV) and cytomegalovirus (CMV) serostatus, gender, and age. Outcomes were assessed with univariable and multivariable Cox proportional hazard models to obtain hazard ratios (HR).17% of the cohort had a diagnosis of CF. PTLD developed in 2% of CF recipients compared to 1% for non-CF recipients (p0.001). Compared to non-CF recipients, CF recipients had higher prevalence of EBV and CMV seronegativity and higher prevalences of high risk EBV and CMV mismatch (D+/R-). There is a significant association between CF and the development of PTLD [HR 1.66 (95% CI 1.30-2.12)]. Stratified multivariable analysis controlling for age revealed EBV negative non-CF recipients have an almost 2 fold increased risk of developing PTLD, whereas EBV negative CF recipients had an almost 6.5 fold increased risk.CF recipients have a higher risk for PTLD compared to non-CF recipients. Further studies are needed to account for additional risk factors and management in this population post-transplant. |
| Databáze: | OpenAIRE |
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