ISSN 1300-4948 | E-ISSN 2148-5607
Pediatric Gastroenterology - Original Article
A single-center experience of post-transplant lymphoproliferative disorder (PTLD) cases after pediatric liver transplantation: Incidence, outcomes, and association with food allergy
1 Department of Pediatric Gastroenterology, Başkent University Hospital, Ankara, Turkey  
2 Department of Pediatric Gastroenterology, Başkent University Faculty of Medicine, Ankara, Turkey  
3 Department of Pediatric Allergy, Başkent University Hospital, Ankara, Turkey  
4 Department of Pathology, Başkent University Hospital, Ankara, Turkey  
5 Department of Pediatric Oncology, Başkent University Hospital, Ankara, Turkey  
6 Department of General Surgery and Transplant Surgery, Başkent University Hospital, Ankara, Turkey  
Turk J Gastroenterol 2018; 29: 354-360
DOI: 10.5152/tjg.2018.17731
Key Words: Post-transplant lymphoproliferative disease, liver transplantation, EBV, food allergy
Abstract

Background/Aims: We evaluated our 16-year single-center experience of pediatric post-transplant lymphoproliferative disorder (PTLD) cases who underwent liver transplantation between 2001 and 2017. 

Materials and Methods: Of the 236 pediatric patients who underwent liver transplantation between 2001 and 2017, the clinical and laboratory data of eight patients diagnosed with PTLD were reviewed. The pre-transplant Epstein-Barr virus (EBV) status of 172 patients was also recorded.

Results: The total incidence of PTLD was 3.4%. The incidence of PTLD was 10% in pre-transplant EBV immunoglobulin G (IgG)-seronegative patients and 0.8% in pre-transplant EBV IgG-seropositive patients. The mean age of the patients at liver transplantation was 2.71±3.21 years, and four patients were aged below 1 year at the time of transplantation. PTLD was diagnosed at 21.81±18.1 months after transplantation. The primary site of involvement was variable among patients: peripheral and mediastinal lymph nodes, stomach and intestine, transplanted graft, bone marrow, and nasopharynx. The eosinophil count varied greatly among patients, with a mean value of 524.62±679/mm3. Three patients had a food allergy and were administered an elimination diet at the time of PTLD diagnosis. Six patients had PTLD of B-cell origin. One patient died due to neutropenic sepsis during chemotherapy, whereas seven patients were followed up in full remission for 7.75±4 years.

Conclusion: PTLD is a life-threatening complication of solid-organ transplantation with a heterogeneous clinical spectrum. Food allergy had a close association with PTLD. A close follow-up of patients with risk factors and an early diagnosis with appropriate treatment may lead to a better outcome.

Cite this article as: Barış Z, Özçay F, Yılmaz Özbek Ö, Haberal N, Sarıalioğlu F, Haberal M. A single-center experience of post-transplant lymphoproliferative disorder (PTLD) cases after pediatric liver transplantation: Incidence, outcomes, and association with food allergy. Turk J Gastroenterol 2018; 29: 354-60.

 

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AVES | Copyright © 2018 Turkish Society of Gastroenterology | Latest Update: 21.05.2018