title: Primary central nervous system posttransplantation lymphoproliferative disorder after heart and lung transplantation.
abstract: Primary central nervous system posttransplantation lymphoproliferative disorder (PCNS-PTLD) is uncommon, especially after heart or lung transplantation. Database analysis from a single heart and lung transplantation centre and a literature review pertaining to PCNS-PTLD was performed. In this study, the prevalence of PCNS-PTLD was 0.18% after heart and/or lung transplants. Of 1674 transplants, three cases of PCNS-PTLD developed 14 months, 9 years and 17 years posttransplant, and all were Epstein-Barr virus driven malignancies. Literature review of the topic revealed predominantly retrospective studies, with most reported cases after renal transplantation. The overall survival is poor, and it may be improved by early diagnosis and treatment. There are no published guidelines on the management of PCNS-PTLD; immune-chemotherapy in conjunction with reduction of immune suppression is preferred based on available evidence.
authors.affiliation: Haematology Department, St Vincent's Hospital, Sydney, New South Wales, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Gifford
authors.affiliation: Haematology Department, St Vincent's Hospital, Sydney, New South Wales, Australia.|Cardiology Department, St Vincent's Hospital, Sydney, New South Wales, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Fay
authors.affiliation: Haematology Department, Royal North Shore Hospital, Sydney, New South Wales, Australia.|Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.|Clinical Faculty, Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Jabbour
authors.affiliation: Haematology Department, St Vincent's Hospital, Sydney, New South Wales, Australia.|Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.|St Vincent's Centre for Applied Medical Research, Sydney, New South Wales, Australia.
authors.forename: D D
authors.initials: DD
authors.lastname: Ma
mesh_terms: D000368:Aged; D002493:Central Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000150:complications / Q000276:immunology / Q000517:prevention & control*; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000276:immunology / Q000517:prevention & control*; D016027:Heart Transplantation; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D015994:Incidence; D016040:Lung Transplantation; D008232:Lymphoproliferative Disorders / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000276:immunology; D011379:Prognosis; D012189:Retrospective Studies; D066027:Transplant Recipients; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents
keywords: central nervous system; heart; lung; lymphoma; posttransplant lymhpoproliferative disorder; transplantation