Post-Transplantation Lymphoproliferative Disorders Localizing to the Gastrointestinal Tract after Liver Transplantation: Report of Five Pediatric Cases
Resource
PEDIATRIC TRANSPLANTATION v.10 n.3 pp.390-394
Journal
PEDIATRIC TRANSPLANTATION
Journal Volume
v.10
Journal Issue
n.3
Pages
390-394
Date Issued
2006
Date
2006
Author(s)
LAI, YU-JEN
NI, YEN-HSUAN
JOU, SHIANN- TARNG
HO, MING-CHIH
WU, JIA-FENG
CHEN, HUEY-LING
HU, REY-HENG
JENG, YUNG-MING
CHANG, MEI-HWEI
LEE, PO-HUANG
Abstract
Post-transplantation lymphoproliferative disorder (PTLD) is a life- threatening complication of organ transplantation. PTLD can occur in every kind of organ transplantation. From July 1992 to July 2004, five patients were diagnosed at our transplantation center with PTLD after pediatric liver transplantation. During this period, there were 52 pediatric patients (<18 yr) receiving an orthotopic liver transplantation (OLT) at our center. All five patients had transmural gastrointestinal (GI) PTLD, which occurred mostly in the stomach and duodenum. Epstein-Barr virus (EBV ) in situ was demonstrated in each case. EBV viral load was noted to be an important risk factor. Treatment included dose reduction of immunosuppressants and anti-CD20 antibody infusion. Chemotherapy, including cyclophosphamide, doxorubicin, vincristine, and prednisolone, was given to three patients. Four patients have survived more than 10 months until now after treatment. The one who was unresponsive to chemotherapy and anti-CD20 antibody had diffuse metastasis and died of systemic candidiasis. In our series, each PTLD involved the GI tract. The mechanism of this phenomenon is unclear, but these five cases indicate the high incidence of PTLD in pediatric solid organ transplantation.
Subjects
post-transplantation lymphoproliferative disorder
pediatric liver transplantation
Epstein-Barr virus
Type
journal article