Post-transplant lymphoproliferative disorder after lung transplantation: A review of 35 cases
| Autor: | Brandon E. Kremer, Jason D. Christie, Jamal G. Misleh, Ran Reshef, Vivek N. Ahya, Stephen J. Schuster, Donald E. Tsai, Nancy P. Blumenthal, Denis Hadjiliadis, Robert M. Kotloff, Edward A. Stadtmauer |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment Kaplan-Meier Estimate Post-transplant lymphoproliferative disorder Organ transplantation Risk Factors hemic and lymphatic diseases Humans Medicine Lung transplantation Lung Survival rate Aged Retrospective Studies Immunosuppression Therapy Transplantation business.industry Incidence Retrospective cohort study Immunosuppression Middle Aged medicine.disease Lymphoproliferative Disorders Surgery Gastrointestinal Tract Survival Rate surgical procedures operative Female Cardiology and Cardiovascular Medicine business Complication Follow-Up Studies Lung Transplantation |
| Zdroj: | The Journal of Heart and Lung Transplantation. 31:296-304 |
| ISSN: | 1053-2498 |
| Popis: | Background Post-transplant lymphoproliferative disorder (PTLD) is a complication of organ transplantation. The risk of developing PTLD varies depending on a number of factors, including the organ transplanted and the degree of immunosuppression used. Methods We report a retrospective analysis of 35 patients with PTLD treated at our center after lung transplantation. Of 705 patients who received allografts, 34 (4.8%) developed PTLD. One patient underwent transplantation elsewhere and was treated at our center. Results PTLD involved the allograft in 49% of our patients and the gastrointestinal (GI) tract lumen in 23%. Histologically, 39% of tumors were monomorphic and 48% polymorphic. The time to presentation defined the location and histology of disease. Of 17 patients diagnosed within 11 months of transplantation, PTLD involved the allograft in 12 (71%) and the GI tract in 1 ( p = 0.01). This "early" PTLD was 85% polymorphic ( p = 0.006). Conversely, of the 18 patients diagnosed more than 11 months after transplant, the lung was involved in 5 (28%) and the GI tract in 7 (39%; p = 0.01). "Late" PTLD was 71% monomorphic ( p = 0.006). Median overall survival after diagnosis was 18.57 months. Overall survival did not differ between all lung transplant recipients and those who developed PTLD. Conclusions PTLD is an uncommon complication after lung transplantation, and its incidence declined remarkably in the era of modern immunosuppression. We report several factors that are important for predisposition toward, progression of, and treatment of PTLD after lung transplantation. |
| Databáze: | OpenAIRE |
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