title: Post-transplant lymphoproliferative disorders and other malignancies after pediatric intestinal transplantation: incidence, clinical features and outcome.
abstract: PTLDs are a well-recognized and potentially fatal complication after intestinal transplantation. We analyzed the incidence, clinical features, and outcome in a 63 intestinal transplantation series performed in our unit between October 1999 and July 2011. Types of graft included ISB (n = 23), LSB (n = 20), and MV (n = 20). Patients were categorized into three groups of immunosuppression: I (n = 43) received basiliximab, tacrolimus, and steroids; II (n = 11) thymoglobulin and tacrolimus, and III (n = 9) alemtuzumab and tacrolimus. EBV status was serially assessed. All PTLD cases were biopsied to establish histopathological diagnosis. The incidence of PTLD was 14.2% (9/63). Median onset of PTLD after transplant was four months (range: 0.5-28), within first postoperative year in 6 (66.6%) patients. Fever was the most common symptom. Graft removal was needed in four patients (44%). The patient survival rate was 66.6% (6/9). We have not found any association between PTLD and immunosuppression regimen or transplant type. However, there was a statistical association with EBV active infection.
authors.affiliation: Intestinal Rehabilitation Unit, University Hospital La Paz, Madrid, Spain. erboluda@salud.madrid.org
authors.forename: Esther
authors.initials: E
authors.lastname: Ramos
authors.forename: Francisco
authors.initials: F
authors.lastname: Hernández
authors.forename: Ane
authors.initials: A
authors.lastname: Andres
authors.forename: Eva
authors.initials: E
authors.lastname: Martínez-Ojinaga
authors.forename: Manuel
authors.initials: M
authors.lastname: Molina
authors.forename: Jesús
authors.initials: J
authors.lastname: Sarría
authors.forename: Manuel
authors.initials: M
authors.lastname: Lopez-Santamaria
authors.forename: Gerardo
authors.initials: G
authors.lastname: Prieto
mesh_terms: D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D000077552:Basiliximab; D002675:Child, Preschool; D020031:Epstein-Barr Virus Infections / Q000150:complications; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects* / Q000379:methods; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007223:Infant; D007422:Intestines / Q000637:transplantation*; D008232:Lymphoproliferative Disorders / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D008297:Male; D011183:Postoperative Complications; D011184:Postoperative Period; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D013256:Steroids / Q000627:therapeutic use; D016559:Tacrolimus / Q000627:therapeutic use; D014180:Transplantation / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D013256:Steroids; D000074323:Alemtuzumab; D000077552:Basiliximab; C512542:thymoglobulin; D016559:Tacrolimus
keywords: Epstein-Barr virus; immunosuppression; intestinal transplantation; post-transplant lymphoproliferative