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Post-transplantation lymphoproliferative disorder in living-donor liver transplantation: a single-center experience

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Abstract

Background

Post-transplantation lymphoproliferative disorder (PTLD) is a group of life-threatening complications of organ transplantation, which occurs most frequently in pediatric patients. This retrospective study evaluates a single-institution experience of five cases of PTLD after living-donor liver transplantation (LDLT).

Patients and method

We reviewed the records of 78 pediatric patients (<18 years old) and 54 adult patients, who underwent LDLT between July 1991 and December 2009.

Result

PTLD was diagnosed in five pediatric patients, yielding an overall incidence of 3.8%. There were no significant differences between the pediatric patients with and those without PTLD in terms of their age, sex, reason for transplantation, calcineurin inhibitor, Epstein–Barr virus (EBV) serostatus, ABO compatibility, lymphocyte cross-matching, or episodes of biopsy proven rejection. Two patients with abdominal lymphadenopathy and one with gastrointestinal PTLD responded to a reduction in immunosuppression. Treatment with rituximab was necessary for another gastrointestinal PTLD patient. Diffuse large-B-cell lymphoma was diagnosed in one patient with mediastinal and lung masses. This patient was treated with chemotherapy and rituximab, followed by surgical resection. All patients survived and no evidence of recurrence has been found since.

Conclusion

Although PTLD is potentially life-threatening, it can be managed by appropriate and prompt treatment, with a good outcome.

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None of the authors have any conflict of interest.

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Authors and Affiliations

  1. Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan

    Chikashi Nakanishi, Naoki Kawagishi, Satoshi Sekiguchi, Yorihiro Akamatsu, Kazushige Sato, Shigehito Miyagi, Ikuo Takeda, Daizo Fukushima, Yoshinobu Kobayashi & Susumu Satomi

  2. Department of Pathology, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan

    Kazuyuki Ishida

  3. Department of Pediatrics, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan

    Hidetaka Niizuma & Shigeru Tsuchiya

  4. Department of Pediatric Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan

    Motoshi Wada & Masaki Nio

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  1. Chikashi Nakanishi
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  2. Naoki Kawagishi
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  3. Satoshi Sekiguchi
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  4. Yorihiro Akamatsu
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  15. Susumu Satomi
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Correspondence to Chikashi Nakanishi.

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Nakanishi, C., Kawagishi, N., Sekiguchi, S. et al. Post-transplantation lymphoproliferative disorder in living-donor liver transplantation: a single-center experience. Surg Today 42, 741–751 (2012). https://doi.org/10.1007/s00595-012-0127-7

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  • DOI: https://doi.org/10.1007/s00595-012-0127-7

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