Adolescent ; Adult ; Bone Marrow Transplantation/adverse effects* ; Bone Marrow Transplantation/mortality ; Female ; Graft Rejection/epidemiology ; Graft Rejection/etiology ; Graft Rejection/mortality ; Humans ; Lymphoproliferative Disorders/epidemiology ; Lymphoproliferative Disorders/etiology* ; Lymphoproliferative Disorders/mortality* ; Male ; Middle Aged ; Organ Transplantation/adverse effects* ; Organ Transplantation/mortality ; Postoperative Complications* ; Prognosis ; Republic of Korea/epidemiology ; Survival Rate ; Time Factors ; Young Adult
Keywords
organ transplantation ; post-transplant lymphoproliferative disorders ; Republic of Korea
Abstract
Post-transplant lymphoproliferative disorders (PTLDs) are a heterogeneous set of complications of organ transplantation associated with poor patient prognosis. We analyzed the clinicopathological features of PTLDs in 43 adult and pediatric recipients of solid organ or bone marrow transplantation at a large transplant service in the Republic of Korea between 1990 and 2009. Of 4545 solid organ and 747 bone marrow transplant recipients, 37 (0.81%) and 6 (0.8%), respectively, developed heterogeneous types of PTLDs. The cumulative incidences of PTLDs during this period were 1.79% (4/223) for heart transplant recipients, 0.78% (17/2192) for kidney transplant recipients, and 0.77% (16/2067) for liver transplant recipients. The patterns of disease onset, histology, and patient survival were associated with the types of organs transplanted. There is a trend for shorter overall survival (OS) in recipients with early-onset PTLDs and monomorphic PTLD histology, while kidney transplant recipients showed favorable OS. This study may be the first comprehensive analysis of the characteristics of PTLDs in Korean patients.