Post-transplant lymphoproliferative disorders in lung transplant recipients: 20-yr experience at the University of Minnesota

Kitsada Wudhikarn, C. J. Holman, M. Linan, A. H. Blaes, J. M. Dunitz, M. E. Hertz, B. A. Peterson

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

Post-transplant lymphoproliferative disorders (PTLD) are potentially fatal complications of solid organ transplantation. The natural history of PTLD varies considerably among the different types of organs transplanted. While lung transplant recipients are highly susceptible to PTLD, there are only a few small studies that detail PTLD in this setting. We undertook this study to better describe the characteristics and treatment response in PTLD after lung transplantation. We conducted a retrospective chart review of lung and heart/lung-transplant recipients between 1985 and 2008. A total of 32 cases (5%) of PTLD were identified in 639 patients. The median interval after transplantation to the diagnosis was 40 (3-242) months. Eight patients (25%) were diagnosed within oneyr of transplantation and had PTLD predominantly within the thorax and allograft. Twenty-four patients (75%) were diagnosed more than one yr after transplantation and their tumors mainly affected the gastrointestinal tract. Monomorphic PTLD, diffuse large B-cell lymphoma, was diagnosed in 91%. Treatment of PTLD varied according to stage and clinical circumstances. Twenty-four patients (75%) have died. The median overall survival was 10 (0-108) months. PTLD after lung transplantation remains a challenge as a result of its frequency, complexity and disappointing outcome.

Original languageEnglish (US)
Pages (from-to)705-713
Number of pages9
JournalClinical Transplantation
Volume25
Issue number5
DOIs
StatePublished - Sep 2011

Keywords

  • Epstein-Barr virus
  • Lung transplantation
  • Post-transplant lymphoproliferative disorders

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