Hepatic involvement by lymphoproliferative disorders post liver transplantation: PTLD.Int. Survey

Abstract

Liver transplant patients exhibiting early deterioration of graft function or other hepatic symptoms should, in addition to assessment for rejection, be evaluated for H-PTLD. In addition, all H-PTLD patients should be evaluated for bone marrow involvement, especially if they are EBV positive. Prospective studies with large patient populations are needed to confirm our results.

Hepatic Lymphomas Post Renal Transplantation May Signify Worse Disease Behavior: Analysis of Data from 26 International Studies

“…However, adding this to the higher rate of multi-organ PTLD in L-PTLD, this study shows a relatively more ominous disease in renal graft recipients whose liver has been complicated by PTLD compared to other disease localizations. In our previous study on liver transplant patients [9], consistent with the current study, we found that disseminated disease is significantly higher in patients representing hepatic localization for the PTLD; however, in that study, no outcome difference has been implicated. Moreover, liver recipients with hepatic PTLD were significantly older at the time of transplantation and had a shorter time to PTLD development, observations which have not been repeated in the current study on kidney recipients.…”

“…Nuckols et al [43] have also found that [43] reported a three times larger share of males in hepatic PTLD in liver recipients. In the current study, we also found that male renal recipients were significantly more likely to develop hepatic PTLD, although in our previous report on liver recipients, we did not find any gender disparity regarding liver involvement by the PTLD [9]. An interesting similar finding of the current study to our previous report on liver transplantation is heart and bone marrow involvement.…”

“…So, in our PTLD questionnaire we tried to gather data of individual patients reported in different published series to make the largest possible population to investigate the impact of these factors. In a previous study, we analyzed hepatic graft involvement by PTLD in liver recipients [9] and in the present study; we explore the same organ complication by PTLD in renal allograft recipients.…”

“…PTLD represents a wide spectrum of abnormal lymphoid proliferations taking place in the setting of ineffective T-cell function due to immunosuppression after organ transplantation. Viral infection most notable for EpsteinBarr virus (EBV), type of organ transplantation, type and potency of immunosuppressive agents employed, and some demographic features of the organ recipients have all been associated with a higher incidence or outcome of PTLD in transplant era [5][6][7][8][9]. As mentioned above, the type of organ transplanted is a key factor in determining the incidence and features of PTLD.…”

CD20 Antigen Expression by Lymphoproliferative Disorders after Kidney Transplant is Independently Associated with a Poor Outcome: PTLD.Int Survey

“…5,6 Other factors that promote lymphoproliferation in solid organ recipients are the type of transplanted organ, the age of the recipient, viral infections other than EBV (eg, hepatotropic viruses), and the recipients' personal vulnerability to develop lymphomas. [7][8][9][10][11] Human cells express several proteins on, in, and within their cell membranes that have a high range of biological functions and can affect their resistance and weakness to several diseases, including PTLD. Several proteins have been identified in human cells, having been proposed relevant in the behavior and prognosis of PTLD.…”