دورية أكاديمية
Post-transplantation lymphoproliferative disease in pediatric liver recipients in Taiwan.
| العنوان: | Post-transplantation lymphoproliferative disease in pediatric liver recipients in Taiwan. |
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| المؤلفون: | Hsu CT; Department of Pediatrics, National Taiwan University Hospital, No. 8, Chung-Shan S. Rd., Taipei, Taiwan. Electronic address: 102899ntuh@gmail.com., Chang MH; Department of Pediatrics, National Taiwan University Hospital, No. 8, Chung-Shan S. Rd., Taipei, Taiwan. Electronic address: changmh@ntu.edu.tw., Ho MC; Department of Surgery, National Taiwan University Hospital, No. 7, Chung-Shan S. Rd., Taipei, Taiwan. Electronic address: mcho1215@ntu.edu.tw., Chang HH; Department of Pediatrics, National Taiwan University Hospital, No. 8, Chung-Shan S. Rd., Taipei, Taiwan. Electronic address: changhh2001@ntu.edu.tw., Lu MY; Department of Pediatrics, National Taiwan University Hospital, No. 8, Chung-Shan S. Rd., Taipei, Taiwan. Electronic address: lmy1079@gmail.com., Jou ST; Department of Pediatrics, National Taiwan University Hospital, No. 8, Chung-Shan S. Rd., Taipei, Taiwan. Electronic address: stjou4@gmail.com., Ni YH; Department of Pediatrics, National Taiwan University Hospital, No. 8, Chung-Shan S. Rd., Taipei, Taiwan. Electronic address: yhni@ntu.edu.tw., Chen HL; Department of Pediatrics, National Taiwan University Hospital, No. 8, Chung-Shan S. Rd., Taipei, Taiwan. Electronic address: hueyling@ntu.edu.tw., Hsu HY; Department of Pediatrics, National Taiwan University Hospital, No. 8, Chung-Shan S. Rd., Taipei, Taiwan. Electronic address: hsuhy@ntu.edu.tw., Wu JF; Department of Pediatrics, National Taiwan University Hospital, No. 8, Chung-Shan S. Rd., Taipei, Taiwan. Electronic address: wjf@ntu.edu.tw. |
| المصدر: | Journal of the Formosan Medical Association = Taiwan yi zhi [J Formos Med Assoc] 2019 Nov; Vol. 118 (11), pp. 1537-1545. Date of Electronic Publication: 2019 Jan 08. |
| نوع المنشور: | Journal Article; Observational Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Formosan Medical Association, Elsevier Country of Publication: Singapore NLM ID: 9214933 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0929-6646 (Print) Linking ISSN: 09296646 NLM ISO Abbreviation: J Formos Med Assoc Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2003- : Singapore : Formosan Medical Association, Elsevier Original Publication: Taipei, Taiwan : Formosan Medical Association, [1991- |
| مواضيع طبية MeSH: | Liver Transplantation/*adverse effects , Lymphoproliferative Disorders/*etiology , Postoperative Complications/*etiology, Adolescent ; Child ; Child, Preschool ; Cytomegalovirus ; Cytomegalovirus Infections/etiology ; Cytomegalovirus Infections/mortality ; Epstein-Barr Virus Infections/etiology ; Epstein-Barr Virus Infections/mortality ; Female ; Graft Rejection/etiology ; Graft Rejection/mortality ; Herpesvirus 4, Human ; Humans ; Infant ; Lymphoma, Large B-Cell, Diffuse/etiology ; Lymphoma, Large B-Cell, Diffuse/mortality ; Lymphoproliferative Disorders/mortality ; Lymphoproliferative Disorders/virology ; Male ; Postoperative Complications/mortality ; Postoperative Complications/virology ; Prognosis ; Retrospective Studies ; Risk Factors ; Survival Rate ; Taiwan |
| مستخلص: | Background: Post-transplantation lymphoproliferative disorder (PTLD) is a heterogeneous, potentially life-threatening complication after liver transplantation in children. In this study, the disease characteristics, outcomes, and prognostic factors of PTLD were investigated. Methods: A retrospective, observational study was conducted on 16 pediatric liver transplant (LT) recipients who developed PTLD between February 2001 and December 2013 at a tertiary referral center in Taiwan. The disease characteristics and treatment outcomes of the patients were analyzed. Results: The median time from liver transplantation to the development of PTLD was 8 months. Early onset (<1 year post-transplantation) PTLD constituted 62.5% of the cases. PTLD location was frequently extranodal (81.3%) and mostly involved the gastrointestinal tract (68.8%). Histopathologic findings showed polymorphic PTLD in six cases (37.5%), diffuse large B-cell lymphoma in five cases (31.3%), and Burkitt's PTLD in two cases (12.5%). Early lesions in PTLD, T-cell lymphoma, and Hodgkin's lymphoma were observed in one case each (6.3%). Overall survival at 1- and 5-years post-PTLD diagnosis was 87.5% and 79.5%, respectively. St Jude's classification stage IV disease was associated with poor survival (hazard ratio [HR] = 13.37, P = 0.037). Two patients (12.5%) had chronic rejection after the treatment for PTLD and one patient (6.3%) developed graft failure. Conclusion: PTLD is a major complication in pediatric LT recipients, but long-term survival is possible in most cases with an adequate treatment strategy. Stage IV disease is a major risk factor for poor survival in pediatric PTLD patients. During the management of PTLD, the possibility of chronic rejection and even graft failure should be considered. (Copyright © 2018 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Cytomegalovirus; Epstein-Barr virus; Liver transplant; Lymphoma; Post-transplantation lympho- proliferative disease |
| تواريخ الأحداث: | Date Created: 20190112 Date Completed: 20200303 Latest Revision: 20200303 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.jfma.2018.12.023 |
| PMID: | 30630698 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 0929-6646 |
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| DOI: | 10.1016/j.jfma.2018.12.023 |