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Published on: February 10, 2018
More benign lymphoproliferative disease after liver transplant in infants
Hossein Khedmat1, Mohammad Ebrahim Ghamar-Chehreh, Mohsen Amini
1Baqiyatallah University of Medical Sciences, Tehran, Iran.
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.
Abstract:
CONTEXT-Despite the high frequency of liver transplants in infants, few data are available on the characteristics of posttransplant lymphoproliferative disorders in liver transplant patients (PTLD). OBJECTIVE-To analyze special features and behavior of PTLD arising after liver transplant in infants. METHODS-A comprehensive search of the literature was conducted for the available data on PTLD in infant liver transplant recipients through PubMed and Google scholar. An infant was defined as a liver recipient who was less than 2 years old at the time of transplant. Overall, 205 cases of PTLD were found in 24 reports, and the 100 infants with PTLD were compared with children and adults with PTLD. RESULTS-PTLD lesions in infants were more likely to be polymorphic whereas monomorphic lesions were more prevalent among older patients (P= .05). Remission rates, metastasis frequency, and organ involvement did not differ significantly between the groups. Survival analysis showed that the infants had a significantly better outcome than did older patients (P= .05). CONCLUSION-PTLD is more benign and may have a better outcome in infant liver transplant recipients than in older recipients. A prospective multicenter approach is needed for future research studies.
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