Post-transplantation lymphoproliferative disorder after liver transplantation: report of 5 cases among more than 550 liver transplants in Iran.
BACKGROUND
Post-transplantation lymphoproliferative disorders (PTLD) are a spectrum of diseases defined as polyclonal or monoclonal proliferations of lymphocytes which occur after solid organ transplants. In this study, we report our first experiences with PTLD following liver transplantation in Iran.


METHODS
We retrospectively analyzed five cases of PTLD which followed liver transplantation among more than 550 liver transplants in our center. Of these, three were pediatric cases and two were adults. The underlying causes were tyrosinemia, autoimmune hepatitis, and progressive familial intrahepatic cholestasis (PFIC) in the three pediatric cases. HCV hepatitis was the primary cause for cirrhosis in one of the adults and the other adult was labeled as cryptogenic cirrhosis. All cases, except for one, developed PTLD during the first year following liver transplantation.


RESULTS
Patients were diagnosed as PTLD, B-cell, MALT and Hodgkin-like (according to the WHO classification of PTLD). The three pediatric patients died despite discontinuation of immunosuppressive drugs and chemotherapy. Fortunately both adult patients, until now, are still alive.


CONCLUSIONS
The incidence of PTLD in our center is lower than previous reports from other centers (0.9%), with a 60% mortality rate and worse prognosis in the pediatric age group.
Geramizadeh
Bita
B
Transplant Center, Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. geramib@sums.ac.ir
Malek-Hosseini
Seyed-Ali
SA
Bahador
Ali
A
Salahi
Heshmatollah
H
Nikeghbalian
Saman
S
Sharifian
Maryam
M
Lankarani
Kamran B
KB
Imanieh
Mohammad-Hadi
MH
Dehghani
Mohsen
M
D000293:Adolescent; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007223:Infant; D007492:Iran / Q000453:epidemiology; D016031:Liver Transplantation / Q000009:adverse effects* / Q000276:immunology*; D008223:Lymphoma / Q000209:etiology* / Q000401:mortality / Q000821:virology; D008297:Male; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D016559:Tacrolimus / Q000627:therapeutic use; D014750:Vincristine / Q000627:therapeutic use
D018931:Antineoplastic Agents, Hormonal; D000972:Antineoplastic Agents, Phytogenic; D007166:Immunosuppressive Agents; D014750:Vincristine; D016572:Cyclosporine; D003520:Cyclophosphamide; D011239:Prednisolone; D009173:Mycophenolic Acid; D016559:Tacrolimus