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In Vitro and In Vivo Assessment of T, B and Myeloid Cells Suppressive Activity and Humoral Responses from Transplant Recipients
Published on: August 12, 2017
Retransplantation after post-transplant lymphoproliferative disorders: an OPTN/UNOS database analysis.
S R Johnson1, W S Cherikh, H M Kauffman
1The Transplant Center, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA. srjohnso@bidmc.harvard.edu
Summary
Retransplantation after post-transplant lymphoproliferative disorders (PTLD) shows excellent patient and graft survival. This study suggests retransplantation is an acceptable option for PTLD survivors, particularly younger patients on tacrolimus-based immunosuppression.
Area of Science:
- Transplantation immunology
- Oncology
- Immunosuppression management
Background:
- Post-transplant lymphoproliferative disorders (PTLD) are a serious complication following organ transplantation.
- The decision for retransplantation in PTLD survivors is often debated.
Purpose of the Study:
- To evaluate the outcomes of retransplantation in patients who developed PTLD.
- To assess patient and graft survival rates after retransplantation in this cohort.
Main Methods:
- A review of the Organ Procurement and Transplant Network/United Network for Organ Sharing database from 1987-2004.
- Analysis of 69 retransplants across various organs (kidney, liver, lung, heart, intestine, pancreas).
- Examination of patient demographics, time to PTLD, time to retransplant, and immunosuppression strategies.
Main Results:
- Most retransplanted patients (50.7%) were under 17 years old at retransplantation.
- Tacrolimus (TAC)-based immunosuppression was more common in retransplants (66.7%) compared to first transplants.
- Excellent patient survival (85.5%) and graft survival (73.9%) were observed at last follow-up.
Conclusions:
- Retransplantation following PTLD is associated with high patient and graft survival rates.
- Younger patients (<17 years) on TAC-based immunosuppression appear to have favorable outcomes.
- Retransplantation should be considered a viable and acceptable treatment option for PTLD survivors.
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