Experience of Post-Transplant Lymphoproliferative Disorder (PTLD) After Pediatric Liver Transplant: Incidence, Outcomes and Association with Food Allergy

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Abstract

Introduction

We evaluated our 16 years of experience of pediatric PTLD cases who were liver transplanted in Başkent University Hospital between 2001-2017 years.

Materials and Methods

We reviewed the clinical and laboratory data of 8 patients who were diagnosed as PTLD out of 236 pediatric patients who were liver transplanted in Başkent University Hospital between 2001-2017 years. Pretransplant EBV statuses of 172 patients were also recorded.

Results

The total PTLD incidence was 3.4%. The incidence of PTLD was 10% in pretransplant EBV IgG negative patients, while it was 0.8% in pretransplant EBV seropositive patients. Mean age of the patients at liver transplant was 2.71±3.21 years; four patients were under 1 year of age at the time of transplant. PTLD was diagnosed 21.81±18.1 months after transplant. The primary site of involvement was variable among patients: peripheral and mediastinal lymph nodes, stomach-intestinal, transplanted graft, bone marrow, and nasopharynx. Eosinophil count varied greatly among patients, with mean values of 524.62±679. Food allergy prevalence was higher than the non-PTLD patients (23/236; 10% versus 3/8; 37.5%) The lymphoproliferative disease was of B cell origin in 6 of the patients. One patient died due to neutropenic sepsis during chemotherapy, while seven patients are being followed up in full remission for 7.75±4 years.

Conclusion

PTLD is a life-threatening complication of solid organ transplantation with a heterogenous clinic. Food allergy had a close association with PTLD. Close follow-up of patients who had risk factors and early diagnosis with appropriate treatment may lead to good outcome.

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