Twenty-year Experience of Post-transplant Lymphoproliferative Disorders in Liver Transplantation, Assessment of Risk Factors, Disease Management and Survival

Media N Ismael, Consuelo Soldevila-Pico and Roniel Cabrera

Department of Internal Medicine Residency, University of Florida, USA
Department of Gastroenterology, University of Florida, USA

^*Correspondance to: Roniel Cabrera 

 PDF  Full Text DOI: 10.25107/2474-1647.2357

Abstract

Background: Post-transplant Lymphoproliferative Disorder (PTLD) is a rare complication that occurs post transplantation. Prognosis and mortality are not well established in adult Liver Transplant (LT). In this study we review LT patients who develop PTLD.
Methods: We retrospectively reviewed adult LT PTLD over a twenty-year period at our transplant center. Diagnosis was confirmed by biopsy. Patient characteristics and survival were assessed.
Results: Nineteen patients had PTLD. Majority were Caucasian, age of 50 years with a slight male predominance at LT. Most common indication for LT was primary sclerosing cholangitis. Median time from LT to diagnosis was 6.48 years. Diffuse large B cell lymphoma was the most common form of PTLD, with a minority of only three patients having EBV in tumor pathology. Five patients passed away within a median of 3.7 months from PTLD diagnosis. Overall 5-year survival from PTLD diagnosis was 77.6%.
Conclusion: Low incidence of PTLD in LT with heterogeneous presentations makes early diagnosis difficult. Use of EBV monitoring to aide detection may be insufficient as the sole screening method. A higher suspicion for vague symptoms may be used in patients with PSC disease. These findings highlight need for multicenter collaborations to better understand this condition.

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Cite the article

Ismael MN, Soldevila-Pico C, Cabrera R. Twenty-year Experience of Posttransplant Lymphoproliferative Disorders in Liver Transplantation, Assessment of Risk Factors, Disease Management and Survival. Clin Surg. 2019; 4: 2357.