Abstract
Post-transplant lymphoproliferative disease (PTLD) has the highest incidence following intestinal transplantation (ITx). Our center has seen a recent increase in PTLD. Our aim was to review a single-center PTLD experience with a focus on clinical characteristics and outcomes. We completed a retrospective review of biopsy-proven PTLD cases using a prospectively maintained database of 115 ITx recipients transplanted between 1991 and 2014. Nineteen (17%) ITx recipients developed 25 PTLD cases during a median follow-up time of 6.4 (1.6-14.6) years. The incidence of early PTLD was 6% (n = 7). There was a trend toward increased risk of PTLD in children compared with adults (P =.11) and a significantly increased risk of PTLD in re-ITx compared with primary ITx recipients (P =.03). Most PTLD cases were diagnosed between 2010 and 2014 (n = 14). All early PTLD cases were EBV+ on in situ hybridization. Overall graft and patient survival are 68% and 74%, respectively. Second episodes of PTLD were diagnosed in 43% of surviving pediatric patients. Our program has a low incidence of early PTLD with overall excellent graft and patient survival following diagnosis. However, we have also seen a rising incidence of late PTLD. The cause of the increase is unknown as no major changes in immunosuppression protocols have occurred since 1999.
Original language | English (US) |
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Article number | e13313 |
Journal | Clinical Transplantation |
Volume | 32 |
Issue number | 8 |
DOIs | |
State | Published - Aug 2018 |
Bibliographical note
Publisher Copyright:© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Keywords
- Epstein-Barr virus
- intestinal transplantation
- post-transplant lymphoproliferative disease