Related Experiment Videos
Current induction immunosuppression and post-heart transplant lymphoproliferative disorders
J R Peraira1, J Segovia, B Fuertes
1Cardiology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain.
Transplantation Proceedings
|September 10, 2003
Summary
Low-dose OKT3 induction therapy in heart transplant recipients did not increase posttransplant lymphoproliferative disorder (PTLD) risk. However, PTLD often appeared late, and mortality remained high despite multidisciplinary treatment.
Area of Science:
- Immunosuppression in Transplantation
- Oncology
- Virology
Background:
- High-dose OKT3 is linked to PTLD in heart transplant (HTx) patients.
- PTLD incidence and characteristics with current protocols are not well-defined.
- This study investigates PTLD in HTx recipients using low-dose OKT3 induction.
Purpose of the Study:
- To determine the incidence of PTLD in heart transplant recipients treated with low-dose OKT3.
- To characterize the clinical presentation and outcomes of PTLD in this cohort.
Main Methods:
- Retrospective review of 560 heart transplant recipients from 1984-2002.
- Analysis of PTLD diagnosis, treatment, and patient outcomes.
- Molecular studies to identify Epstein-Barr virus (EBV) and cell proliferation type.
Main Results:
- PTLD incidence was 1% (6/560 patients).
- Disease onset varied, with late presentation in 4/6 cases (13-121 months post-transplant).
- Four cases showed Epstein-Barr virus (EBV) association; five had B-cell, one had T-cell proliferation. Mortality was 67%.
Conclusions:
- Low-dose OKT3 induction therapy did not elevate PTLD incidence in this HTx series.
- Late-onset PTLD was more common in this cohort.
- Despite varied treatments, including OKT3 for T-cell PTLD, overall mortality remained high.