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Post-transplant lymphoproliferative disorders in liver transplant recipients: a clinicopathological study
  1. Regina Cheuk-lam Lo1,3,
  2. See-ching Chan2,3,
  3. Kwong-leung Chan2,
  4. Alan Kwok-shing Chiang4,
  5. Chung-mau Lo2,3,
  6. Irene Oi-lin Ng1,3
  1. 1Department of Pathology, The University of Hong Kong, Hong Kong, Hong Kong
  2. 2Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong
  3. 3State Key Laboratory for Liver Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
  4. 4Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong
  1. Correspondence to Professor Irene Oi-Lin Ng, Department of Pathology, Room 127B, University Pathology Building, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong; iolng{at}hku.hk

Abstract

Background and aims Complications after liver transplantation are major factors that determine the prognosis of patients. In this study, we aimed at investigating an important though less frequently occurring complication, post-transplant lymphoproliferative disorders (PTLD), in a single institution after liver transplantation.

Methods 15 cases with a diagnosis of PTLD in post-liver transplant patients were retrieved from our archive and the clinicopathological features reviewed.

Results The overall incidence of PTLD was 2.3% (n=15/658), and the incidence was much higher in the paediatric than the adult age groups, being 11.1% (9/81) and 1% (6/577), respectively. The median time of presentation was 16 months after transplantation (occurrence time ranging from 2 to 87 months after transplantation). Lymph nodes, gastrointestinal tract and graft liver were the commonest sites of involvement. 11 cases were classified as monomorphic PTLD according to WHO classification and the majority (n=10/11) of them were of B cell differentiation. 12 of the total 15 PTLD cases showed a positive result for Epstein-Barr virus-encoded RNAs with in situ hybridisation. Eight patients were alive at the time of review, and two of them suffered from recurrence of the PTLD. Among the seven patients who died, six succumbed within 1 year from the diagnosis of PTLD.

Conclusions Despite its relative rarity as a complication for liver transplantation, PTLD imposes significant effects on the morbidity, mortality and treatment implications in postliver transplant patients. The clinicopathological data would hopefully provide better insight into the surveillance and management for susceptible patients.

  • Cancer
  • Cancer Genetics
  • Liver Cancer

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