Posttransplant lymphoproliferative disorder (PTLD) is a well-known complication of organ transplantation that leads to death in more than 50% of cases.
In this study, a team of researchers from France assessed 480 consecutive patients (323 men, 157 women; mean age = 50 years) who underwent transplantation between 1986 and 1997.
The team analyzed demographics, indication for transplantation, immunosuppressive regimens, incidence of rejection episodes, and Epstein-Barr virus infection in all patients.
|Risk factors for PTLD:|
- use of antilymphocyte antibodies
- liver transplant for HCV cirrhosis
- liver transplant for alcoholic cirrhosis
- age older than 50 years
They used univariate and multivariate analyses to identify factors predictive of PTLD.
The research team identified 16 cases of PTLD, which occurred a median of 6 months after liver transplantation.
All 16 cases occurred in patients with evidence of exposure to Epstein-Barr virus before transplantation.
In addition, the team found that the use of antilymphocyte antibodies, liver transplantation for HCV cirrhosis and for alcoholic cirrhosis, and age older than 50 years were independently associated with the onset of PTLD.
Dr Christophe Duvoux's team concluded, "Liver transplantation for hepatitis C virus-related and alcoholic cirrhosis and age older than 50 years are three additional risk factors for lymphoproliferative disorder independent of the use of antilymphocyte antibodies".
"The use of antilymphocyte antibodies after liver transplantation should be avoided in these categories of patients, especially those older than 50 years".