title: Post-transplantation lymphoproliferative disorder in living-donor liver transplantation: a single-center experience.
abstract: BACKGROUND
  Post-transplantation lymphoproliferative disorder (PTLD) is a group of life-threatening complications of organ transplantation, which occurs most frequently in pediatric patients. This retrospective study evaluates a single-institution experience of five cases of PTLD after living-donor liver transplantation (LDLT).
  
  
  METHODS
  We reviewed the records of 78 pediatric patients (<18 years old) and 54 adult patients, who underwent LDLT between July 1991 and December 2009.
  
  
  RESULTS
  PTLD was diagnosed in five pediatric patients, yielding an overall incidence of 3.8%. There were no significant differences between the pediatric patients with and those without PTLD in terms of their age, sex, reason for transplantation, calcineurin inhibitor, Epstein-Barr virus (EBV) serostatus, ABO compatibility, lymphocyte cross-matching, or episodes of biopsy proven rejection. Two patients with abdominal lymphadenopathy and one with gastrointestinal PTLD responded to a reduction in immunosuppression. Treatment with rituximab was necessary for another gastrointestinal PTLD patient. Diffuse large-B-cell lymphoma was diagnosed in one patient with mediastinal and lung masses. This patient was treated with chemotherapy and rituximab, followed by surgical resection. All patients survived and no evidence of recurrence has been found since.
  
  
  CONCLUSIONS
  Although PTLD is potentially life-threatening, it can be managed by appropriate and prompt treatment, with a good outcome.
authors.affiliation: Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. chikashi-n@world.ocn.ne.jp
authors.forename: Chikashi
authors.initials: C
authors.lastname: Nakanishi
authors.forename: Naoki
authors.initials: N
authors.lastname: Kawagishi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sekiguchi
authors.forename: Yorihiro
authors.initials: Y
authors.lastname: Akamatsu
authors.forename: Kazushige
authors.initials: K
authors.lastname: Sato
authors.forename: Shigehito
authors.initials: S
authors.lastname: Miyagi
authors.forename: Ikuo
authors.initials: I
authors.lastname: Takeda
authors.forename: Daizo
authors.initials: D
authors.lastname: Fukushima
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Ishida
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Niizuma
authors.forename: Shigeru
authors.initials: S
authors.lastname: Tsuchiya
authors.forename: Motoshi
authors.initials: M
authors.lastname: Wada
authors.forename: Masaki
authors.initials: M
authors.lastname: Nio
authors.forename: Susumu
authors.initials: S
authors.lastname: Satomi
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D015994:Incidence; D007223:Infant; D016031:Liver Transplantation; D019520:Living Donors; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies; D000069283:Rituximab; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069283:Rituximab