title: Adult post-transplant lymphoproliferative disease in the liver graft in patients with recurrent hepatitis C.
abstract: OBJECTIVE
  The aim of this study is to clarify the association between hepatitis C virus (HCV) infection and post-transplant lymphoproliferative disease (PTLD) in the liver allograft.
  
  
  METHODS
  Of the 933 adults who underwent liver transplantation (LT) between 1990 and 2005, 10 patients developed PTLD. Seven of the 10 patients that were HCV(+) (group 1) were compared with three HCV-negative recipients (group 2).
  
  
  RESULTS
  The mean time between LT and PTLD was 24.5 months. There were no differences between in Epstein-Barr virus antibody status or tumor lymphocyte subsets. In five of the seven HCV-positive recipients who developed PTLD, PTLD recurred preferentially in the liver allograft, whereas none of the three HCV-negative patients who developed PTLD did so in the liver (71.4 vs. 0%, respectively, P=0.038). In all five patients with graft PTLD, HCV recurred within 12 months followed by PTLD. There were significant differences between groups 1 and 2 in mean lymphocyte infiltrate scores (6.0±2.1 vs. 2.0±0.7, P=0.037), fibrosis stage (2.4±0.5 vs. 0.7±0.5, P=0.029), and frequency of lymphoid follicles in portal areas (33.6±14.8% vs. 1.1±2.3%, P=0.0002).
  
  
  CONCLUSIONS
  When PTLD occurs in patients with HCV recurrence after LT, it does so preferentially in the liver allograft.
authors.affiliation: Section of Transplantation, Department of Surgery, University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT 84103, USA. robin.kim@hsc.utah.edu
authors.forename: Robin D
authors.initials: RD
authors.lastname: Kim
authors.forename: Takahisa
authors.initials: T
authors.lastname: Fujikawa
authors.forename: Shugo
authors.initials: S
authors.lastname: Mizuno
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Schwartz
authors.forename: John B
authors.initials: JB
authors.lastname: Sorensen
authors.forename: Alan W
authors.initials: AW
authors.lastname: Hemming
authors.forename: Shiro
authors.initials: S
authors.lastname: Fujita
mesh_terms: D000293:Adolescent; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D001379:Azathioprine / Q000627:therapeutic use; D015331:Cohort Studies; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D006526:Hepatitis C / Q000097:blood / Q000150:complications* / Q000276:immunology / Q000821:virology; D004854:Herpesvirus 4, Human / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation / Q000009:adverse effects* / Q000276:immunology; D008232:Lymphoproliferative Disorders / Q000097:blood / Q000209:etiology* / Q000276:immunology / Q000821:virology; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011183:Postoperative Complications / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D013256:Steroids / Q000627:therapeutic use; D016559:Tacrolimus / Q000627:therapeutic use
chemical_list: D000914:Antibodies, Viral; D007166:Immunosuppressive Agents; D013256:Steroids; D016572:Cyclosporine; D009173:Mycophenolic Acid; D001379:Azathioprine; D016559:Tacrolimus