Risk factors for adenotonsillar hypertrophy in children following solid organ transplantation
| Autor: | Neil Bhattacharyya, Nina L. Shapiro, Ali M. Strocker |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Graft Rejection
Male Epstein-Barr Virus Infections medicine.medical_specialty Adolescent Cross-sectional study Palatine Tonsil Population Physical examination Risk Assessment Postoperative Complications Internal medicine Epidemiology medicine Humans Registries Risk factor Child education Probability education.field_of_study medicine.diagnostic_test business.industry Incidence Incidence (epidemiology) Graft Survival Hypertrophy Organ Transplantation General Medicine Prognosis Kidney Transplantation Lymphoproliferative Disorders Liver Transplantation Surgery Transplantation Cross-Sectional Studies Otorhinolaryngology Child Preschool Adenoids Multivariate Analysis Pediatrics Perinatology and Child Health Linear Models Female business Complication |
| Zdroj: | International Journal of Pediatric Otorhinolaryngology. 67:151-155 |
| ISSN: | 0165-5876 |
| DOI: | 10.1016/s0165-5876(02)00356-7 |
| Popis: | Summary Objective: Post-transplantation lymphoproliferative disorder (PTLD), or its precursor, Epstein-Barr virus (EBV)-related lymphoid hyperplasia, may first present in the tonsils and adenoids in the pediatric solid organ transplant population. We sought to identify signs and symptoms of and risk factors for adenotonsillar hypertrophy (ATH), a potential precursor to PTLD in children following solid organ transplantation. Methods: We performed a cross-sectional study of 132 consecutive pediatric solid organ transplant patients at our institution. Questionnaire, physical examination, and laboratory data collection were obtained. Correlation of signs and symptoms of ATH with objective laboratory data was conducted. Results: 132 pediatric transplant recipients (64 renal, 68 liver) were enrolled. Mean age at transplantation was 7.4 (S.D. 6.0) years with a mean follow-up of 49.0 (S.D. 48.4) months post-transplantation. The mean questionnaire score was 8.4 (S.D. 7.9) out of a maximum 65 and the mean physical examination score was 3.9 (S.D. 1.9) out of a maximum 8, with a statistically significant correlation between the two (Pearson’s r � /0.352, P B/0.001). A multivariate linear regression model found recipient EBV seronegativity and younger age at transplantation to be statistically significant risk factors for development of ATH (P � /0.024 and 0.035, respectively). Conclusions: Young age and EBV seronegativity confer increased risk for ATH in pediatric patients undergoing solid organ transplantation. As ATH may be the earliest sign of PTLD, long-term surveillance is required to determine the impact of ATH on quality of life and survival in these patients. |
| Databáze: | OpenAIRE |
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