title: Post-transplant lymphoproliferative disorder after adult-to-adult living donor liver transplant: case series and review of literature.
abstract: Post-transplant lymphoproliferative disorder (PTLD) is a serious complication of solid organ transplant. Although living donor liver transplant (LDLT) has been increasingly performed, PTLD after LDLT has not been well investigated. We aimed to determine the clinical characteristics of PTLD after LDLT. We investigated 323 consecutive patients undergoing adult-to-adult LDLT and identified three patients who developed biopsy-proven PTLD. All of them were seropositive for Epstein-Barr virus (EBV) and had hepatitis C virus-related cirrhosis at transplant. All three patients developed late-onset and monomorphic PTLD, including one diffuse large B-cell lymphoma and two Burkitt lymphomas with c-myc rearrangement. Two of them were EBV negative. The initial therapy included chemotherapy, rituximab, and immunosuppression withdrawal. One patient died of sepsis during treatment and two patients achieved complete responses. We showed a relatively low incidence and distinct clinicopathological features of PTLD after adult-to-adult LDLT, which might reflect the unique nature of LDLT.
authors.affiliation: Department of Hematology & Oncology, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kataoka
authors.forename: Sachiko
authors.initials: S
authors.lastname: Seo
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ota
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Imai
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takahashi
authors.forename: Masashi
authors.initials: M
authors.lastname: Fukayama
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
authors.forename: Mineo
authors.initials: M
authors.lastname: Kurokawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000821:virology; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008232:Lymphoproliferative Disorders / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D012196:Review Literature as Topic; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult