More benign lymphoproliferative disease after liver transplant in infants

Hossein Khedmat1, Mohammad Ebrahim Ghamar-Chehreh, Mohsen Amini

  • 1Baqiyatallah University of Medical Sciences, Tehran, Iran.

Progress in Transplantation (Aliso Viejo, Calif.)
|June 21, 2013
PubMed

Insights

Posttransplant lymphoproliferative disorders (PTLD) in infants after liver transplants are more often polymorphic and have a better outcome compared to older patients. Further research is needed.

Area of Science:

  • Pediatric Gastroenterology and Hepatology
  • Transplant Immunology
  • Oncology

Background:

  • Liver transplantation is common in infants, yet data on posttransplant lymphoproliferative disorders (PTLD) are scarce.
  • PTLD presents unique challenges in pediatric recipients.

Purpose of the Study:

  • To investigate the specific characteristics and clinical behavior of PTLD in infant liver transplant recipients.
  • To compare PTLD in infants with that in older pediatric and adult liver transplant recipients.

Main Methods:

  • A systematic literature review was performed using PubMed and Google Scholar.
  • Data from 205 PTLD cases across 24 reports were analyzed, focusing on 100 infant recipients (<2 years old at transplant).
  • Infant PTLD cases were compared with those in older children and adults.

Main Results:

  • PTLD lesions in infants were more frequently polymorphic compared to monomorphic lesions in older patients (P = .05).
  • Remission rates, metastasis frequency, and organ involvement showed no significant differences between age groups.
  • Infant liver transplant recipients with PTLD demonstrated a significantly better survival outcome (P = .05).

Conclusions:

  • PTLD in infant liver transplant recipients appears to be more benign with a favorable prognosis.
  • A prospective, multicenter research approach is recommended for further investigation.