Analysis of Risk Factors for the Development of Posttransplant Lymphoprolipherative Disorder Among 119 Children Who Received Primary Intestinal Transplants at a Single Center

C. Quintini, T. Kato, Jeffrey Gaynor, T. Ueno, Gennaro Selvaggi, P. Gordon, Gwenn E McLaughlin, J. Tompson, Phillip Ruiz, A. Tzakis

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Abstract

Posttransplant lymphoproliferative disorder (PTLD) is a well-known complication after pediatric transplantation. We analyzed all potential risk factors to assess patient and graft outcomes of 119 children who received intestinal transplantations. Materials and Methods: Between August 1994 and March 2005, 119 patients underwent cadaveric intestinal transplantation. Their median age at transplant was 1.4 years (range: 0.6-17), median weight was 9.5 kg (range: 4.7-67), and 57% were boys. The median follow-up among 49 ongoing survivors was 41 months (range: 4-121). All PTLD cases were biopsy proven. In the past 5 years, treatment included antiviral therapy, immunosuppression withdrawal, and use of rituximab. Results: The incidence of PTLD was 11.8% (14/119). No patient experienced graft failure secondary to PTLD, while two patients died from PTLD (14.2%). The PTLD group was divided into an early onset group (<4 months, 6 of 14; 42.8%) and a late onset group (>2 years, 8 of 14; 57.2%). No patient experienced PTLD between 4 months and 2 years after transplantation. The use of OKT3 was the only significant risk factor for the development of PTLD. No factor was specifically associated with the early versus late development of PTLD. Conclusions: The only factor associated with a significantly higher risk of PTLD was the use of OKT3 to treat a rejection episode. Finally, since the the introduction of anti-CD20 antibodies as part of the treatment protocol for PTLD, the risk of death due to PTLD appears to have become manageably low.

Original languageEnglish
Pages (from-to)1755-1758
Number of pages4
JournalTransplantation Proceedings
Volume38
Issue number6
DOIs
StatePublished - Jul 1 2006

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Lymphoproliferative Disorders
Transplants
Transplantation
Muromonab-CD3
Clinical Protocols
Immunosuppression
Antiviral Agents
Survivors
Anti-Idiotypic Antibodies

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

@article{a8d0f11effc946c3a64b958bbc5b0512,
title = "Analysis of Risk Factors for the Development of Posttransplant Lymphoprolipherative Disorder Among 119 Children Who Received Primary Intestinal Transplants at a Single Center",
abstract = "Posttransplant lymphoproliferative disorder (PTLD) is a well-known complication after pediatric transplantation. We analyzed all potential risk factors to assess patient and graft outcomes of 119 children who received intestinal transplantations. Materials and Methods: Between August 1994 and March 2005, 119 patients underwent cadaveric intestinal transplantation. Their median age at transplant was 1.4 years (range: 0.6-17), median weight was 9.5 kg (range: 4.7-67), and 57{\%} were boys. The median follow-up among 49 ongoing survivors was 41 months (range: 4-121). All PTLD cases were biopsy proven. In the past 5 years, treatment included antiviral therapy, immunosuppression withdrawal, and use of rituximab. Results: The incidence of PTLD was 11.8{\%} (14/119). No patient experienced graft failure secondary to PTLD, while two patients died from PTLD (14.2{\%}). The PTLD group was divided into an early onset group (<4 months, 6 of 14; 42.8{\%}) and a late onset group (>2 years, 8 of 14; 57.2{\%}). No patient experienced PTLD between 4 months and 2 years after transplantation. The use of OKT3 was the only significant risk factor for the development of PTLD. No factor was specifically associated with the early versus late development of PTLD. Conclusions: The only factor associated with a significantly higher risk of PTLD was the use of OKT3 to treat a rejection episode. Finally, since the the introduction of anti-CD20 antibodies as part of the treatment protocol for PTLD, the risk of death due to PTLD appears to have become manageably low.",
author = "C. Quintini and T. Kato and Jeffrey Gaynor and T. Ueno and Gennaro Selvaggi and P. Gordon and McLaughlin, {Gwenn E} and J. Tompson and Phillip Ruiz and A. Tzakis",
year = "2006",
month = "7",
day = "1",
doi = "10.1016/j.transproceed.2006.05.039",
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TY - JOUR

T1 - Analysis of Risk Factors for the Development of Posttransplant Lymphoprolipherative Disorder Among 119 Children Who Received Primary Intestinal Transplants at a Single Center

AU - Quintini, C.

AU - Kato, T.

AU - Gaynor, Jeffrey

AU - Ueno, T.

AU - Selvaggi, Gennaro

AU - Gordon, P.

AU - McLaughlin, Gwenn E

AU - Tompson, J.

AU - Ruiz, Phillip

AU - Tzakis, A.

PY - 2006/7/1

Y1 - 2006/7/1

N2 - Posttransplant lymphoproliferative disorder (PTLD) is a well-known complication after pediatric transplantation. We analyzed all potential risk factors to assess patient and graft outcomes of 119 children who received intestinal transplantations. Materials and Methods: Between August 1994 and March 2005, 119 patients underwent cadaveric intestinal transplantation. Their median age at transplant was 1.4 years (range: 0.6-17), median weight was 9.5 kg (range: 4.7-67), and 57% were boys. The median follow-up among 49 ongoing survivors was 41 months (range: 4-121). All PTLD cases were biopsy proven. In the past 5 years, treatment included antiviral therapy, immunosuppression withdrawal, and use of rituximab. Results: The incidence of PTLD was 11.8% (14/119). No patient experienced graft failure secondary to PTLD, while two patients died from PTLD (14.2%). The PTLD group was divided into an early onset group (<4 months, 6 of 14; 42.8%) and a late onset group (>2 years, 8 of 14; 57.2%). No patient experienced PTLD between 4 months and 2 years after transplantation. The use of OKT3 was the only significant risk factor for the development of PTLD. No factor was specifically associated with the early versus late development of PTLD. Conclusions: The only factor associated with a significantly higher risk of PTLD was the use of OKT3 to treat a rejection episode. Finally, since the the introduction of anti-CD20 antibodies as part of the treatment protocol for PTLD, the risk of death due to PTLD appears to have become manageably low.

AB - Posttransplant lymphoproliferative disorder (PTLD) is a well-known complication after pediatric transplantation. We analyzed all potential risk factors to assess patient and graft outcomes of 119 children who received intestinal transplantations. Materials and Methods: Between August 1994 and March 2005, 119 patients underwent cadaveric intestinal transplantation. Their median age at transplant was 1.4 years (range: 0.6-17), median weight was 9.5 kg (range: 4.7-67), and 57% were boys. The median follow-up among 49 ongoing survivors was 41 months (range: 4-121). All PTLD cases were biopsy proven. In the past 5 years, treatment included antiviral therapy, immunosuppression withdrawal, and use of rituximab. Results: The incidence of PTLD was 11.8% (14/119). No patient experienced graft failure secondary to PTLD, while two patients died from PTLD (14.2%). The PTLD group was divided into an early onset group (<4 months, 6 of 14; 42.8%) and a late onset group (>2 years, 8 of 14; 57.2%). No patient experienced PTLD between 4 months and 2 years after transplantation. The use of OKT3 was the only significant risk factor for the development of PTLD. No factor was specifically associated with the early versus late development of PTLD. Conclusions: The only factor associated with a significantly higher risk of PTLD was the use of OKT3 to treat a rejection episode. Finally, since the the introduction of anti-CD20 antibodies as part of the treatment protocol for PTLD, the risk of death due to PTLD appears to have become manageably low.

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U2 - 10.1016/j.transproceed.2006.05.039

DO - 10.1016/j.transproceed.2006.05.039

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JO - Transplantation Proceedings

JF - Transplantation Proceedings

SN - 0041-1345

IS - 6

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