Posttransplant lymphoproliferative disorders in lung transplant recipients: clinical experience at a single center.
OBJECTIVE
Posttransplant lymphoproliferative disorders (PTLD) can be a significant cause of morbidity in lung transplant (LT) recipients. Risk factors include Epstein-Barr virus (EBV) infection, particularly primary infection, and immunosuppression. This article updates the incidence and presentation of PTLD at our lung transplant program.


METHODS
We retrospectively reviewed the immunosuppression, EBV serology, and cases of PTLD among 129 lung transplant recipients at risk who survived > 1 month.


RESULTS
There were two cases of PTLD among 129 LT patients, 2/129 (1.6%). One of these patients was among the 6 EBV seroconverters, 1/6 (16.7%), and had a typical presentation of PTLD in the allograft resulting in dissemination and death. The second case of PTLD developed in an EBV seropositive recipient who presented 33 months following LT with isolated colonic involvement. He subsequently died from chronic rejection.


CONCLUSIONS
The incidence of PTLD in a LT program with a large EBV seropositive population is low, 1.6%. The presentation of PTLD in LT recipients is variable and may present typically with allograft involvement in the first year following transplantation, or late with isolated, extrapulmonic involvement.
Angel
L F
LF
Department of Medicine, Division of Pulmonary Diseases/Critical Care Medicine, University of Texas Health Science Center at San Antonio and the South Texas Veterans Health Care System, Audie L Murphy Division, San Antonio, Texas, USA.
Cai
T H
TH
Sako
E Y
EY
Levine
S M
SM
D000328:Adult; D003110:Colonic Neoplasms / Q000209:etiology; D020031:Epstein-Barr Virus Infections / Q000209:etiology; D005260:Female; D006084:Graft Rejection / Q000209:etiology; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D008175:Lung Neoplasms / Q000209:etiology; D016040:Lung Transplantation / Q000009:adverse effects*; D016393:Lymphoma, B-Cell / Q000209:etiology; D008232:Lymphoproliferative Disorders / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies