Abstract
Background: Posttransplant lymphoproliferative disease (PTLD) is a serious complication in transplant recipients. Abdominal PTLD has been reported, but the prognosis remains undefined. The purpose of this study was to identify the incidence, predisposing factors, and outcome of abdominal PTLD in pediatric cardiothoracic transplant patients. Methods: Retrospective chart review of 134 transplant patients (50 heart, 77 lung, 7 heart/lung) at our institution (1995-2005). Results: Posttransplant lymphoproliferative disease was diagnosed in 14 patients. Most were Epstein-Barr virus naive initially, but all had seroconverted when diagnosed with PTLD. Eight had abdominal involvement; 4 required surgical interventions-1 for intussusception and for bowel perforation, 2 for bowel perforation, and 1 for tumor debulking. All had lifelong follow-up, with an average follow-up of 3 years. Of 8 patients with abdominal PTLD, 4 died of complications related to PTLD, whereas 1 of 6 patients with extraabdominal PTLD died of PTLD. Conclusions: Epstein-Barr virus infection after transplantation is a major risk factor for PTLD. Pediatric patients with PTLD who present with abdominal involvement are more likely to die of PTLD than those without abdominal disease. Delay in diagnosis may contribute to the high mortality. Therefore, prompt evaluation and surveillance for possible abdominal PTLD may decrease mortality associated with this devastating problem.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2174-2177 |
| Number of pages | 4 |
| Journal | Journal of Pediatric Surgery |
| Volume | 43 |
| Issue number | 12 |
| DOIs | |
| State | Published - Dec 1 2008 |
| Externally published | Yes |
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Keywords
- Pediatric heart transplantation
- Pediatric lung transplantation
- Posttransplant lymphoproliferative disease
ASJC Scopus subject areas
- Surgery
- Pediatrics, Perinatology, and Child Health
Cite this
Abdominal involvement in pediatric heart and lung transplant recipients with posttransplant lymphoproliferative disease increases the risk of mortality. / Tai, Cindy C.; Curtis, Jennifer L.; Szmuszkovicz, Jacqueline R.; Horn, Monica V.; Ford, Henri; Woo, Marlyn S.; Wang, Kasper S.
In: Journal of Pediatric Surgery, Vol. 43, No. 12, 01.12.2008, p. 2174-2177.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Abdominal involvement in pediatric heart and lung transplant recipients with posttransplant lymphoproliferative disease increases the risk of mortality
AU - Tai, Cindy C.
AU - Curtis, Jennifer L.
AU - Szmuszkovicz, Jacqueline R.
AU - Horn, Monica V.
AU - Ford, Henri
AU - Woo, Marlyn S.
AU - Wang, Kasper S.
PY - 2008/12/1
Y1 - 2008/12/1
N2 - Background: Posttransplant lymphoproliferative disease (PTLD) is a serious complication in transplant recipients. Abdominal PTLD has been reported, but the prognosis remains undefined. The purpose of this study was to identify the incidence, predisposing factors, and outcome of abdominal PTLD in pediatric cardiothoracic transplant patients. Methods: Retrospective chart review of 134 transplant patients (50 heart, 77 lung, 7 heart/lung) at our institution (1995-2005). Results: Posttransplant lymphoproliferative disease was diagnosed in 14 patients. Most were Epstein-Barr virus naive initially, but all had seroconverted when diagnosed with PTLD. Eight had abdominal involvement; 4 required surgical interventions-1 for intussusception and for bowel perforation, 2 for bowel perforation, and 1 for tumor debulking. All had lifelong follow-up, with an average follow-up of 3 years. Of 8 patients with abdominal PTLD, 4 died of complications related to PTLD, whereas 1 of 6 patients with extraabdominal PTLD died of PTLD. Conclusions: Epstein-Barr virus infection after transplantation is a major risk factor for PTLD. Pediatric patients with PTLD who present with abdominal involvement are more likely to die of PTLD than those without abdominal disease. Delay in diagnosis may contribute to the high mortality. Therefore, prompt evaluation and surveillance for possible abdominal PTLD may decrease mortality associated with this devastating problem.
AB - Background: Posttransplant lymphoproliferative disease (PTLD) is a serious complication in transplant recipients. Abdominal PTLD has been reported, but the prognosis remains undefined. The purpose of this study was to identify the incidence, predisposing factors, and outcome of abdominal PTLD in pediatric cardiothoracic transplant patients. Methods: Retrospective chart review of 134 transplant patients (50 heart, 77 lung, 7 heart/lung) at our institution (1995-2005). Results: Posttransplant lymphoproliferative disease was diagnosed in 14 patients. Most were Epstein-Barr virus naive initially, but all had seroconverted when diagnosed with PTLD. Eight had abdominal involvement; 4 required surgical interventions-1 for intussusception and for bowel perforation, 2 for bowel perforation, and 1 for tumor debulking. All had lifelong follow-up, with an average follow-up of 3 years. Of 8 patients with abdominal PTLD, 4 died of complications related to PTLD, whereas 1 of 6 patients with extraabdominal PTLD died of PTLD. Conclusions: Epstein-Barr virus infection after transplantation is a major risk factor for PTLD. Pediatric patients with PTLD who present with abdominal involvement are more likely to die of PTLD than those without abdominal disease. Delay in diagnosis may contribute to the high mortality. Therefore, prompt evaluation and surveillance for possible abdominal PTLD may decrease mortality associated with this devastating problem.
KW - Pediatric heart transplantation
KW - Pediatric lung transplantation
KW - Posttransplant lymphoproliferative disease
UR - http://www.scopus.com/inward/record.url?scp=56449112171&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=56449112171&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2008.08.044
DO - 10.1016/j.jpedsurg.2008.08.044
M3 - Article
C2 - 19040929
AN - SCOPUS:56449112171
VL - 43
SP - 2174
EP - 2177
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 12
ER -