Features, predictors and prognosis of lymphoproliferative disorders post-liver transplantation regarding disease presentation time: Report from the PTLD.Int. survey
Morteza Izadi, Saeed Taheri
Ann Transplant 2011; 16(1): 39-47
Background: The present study deals with different aspects of PTLD in a very large number of liver transplant recipients, whose data recruited from 30 previous reports, with regard to their presentation time.
Material/Methods: We conducted a comprehensive search for the available data by Pubmed and Google scholar search engines for reports indicating presentation time in PTLD patients. Data from 30 previously published studies were included into analysis. Finally, 231 recipients of liver allograft were included into analysis.
Results: Recipients with early onset PTLD were significantly more likely to represent EBV positive test results (p=0.0003). Recipients with late onset PTLD represented a significantly higher risk of disseminated disease (p=0.049). Late onset PTLD more frequently represented monomorphic lesions (p=0.005). Hodgkin and Hodgkin like diseases also had a trend to occur in the late period after transplantation (p=0.076), although it did not reach significance level. Liver allograft involvement was more often observed in the early onset PTLD (p<0.0001), while colon involvement in the late onset disease (p=0.04). One and five years survival rates for early onset PTLD patients were 64% and 54%, respectively; compared to 73% and 50%, respectively, for the control group (p>0.1).
Conclusions: Due to a higher incidence of liver involvement in the early onset PTLD patients and colon involvement in late onset PTLD, authors suggest that liver graft recipients should receive enough evaluations for a potential multi organ disease based on their presentation time. Further multi-institutional prospective studies are needed to confirm our results.
Keywords: post transplant lymphoproliferative disorders, Liver Transplantation - adverse effects, late onset, early onset