Angel L F, Cai T H, Sako E Y, Levine S M
Department of Medicine, Division of Pulmonary Diseases/Critical Care Medicine, University of Texas Health Science Center at San Antonio and the South Texas Veterans Health Care System, Audie L Murphy Division, San Antonio, Texas, USA.
Ann Transplant. 2000;5(3):26-30.
Posttransplant lymphoproliferative disorders (PTLD) can be a significant cause of morbidity in lung transplant (LT) recipients. Risk factors include Epstein-Barr virus (EBV) infection, particularly primary infection, and immunosuppression. This article updates the incidence and presentation of PTLD at our lung transplant program.
We retrospectively reviewed the immunosuppression, EBV serology, and cases of PTLD among 129 lung transplant recipients at risk who survived > 1 month.
There were two cases of PTLD among 129 LT patients, 2/129 (1.6%). One of these patients was among the 6 EBV seroconverters, 1/6 (16.7%), and had a typical presentation of PTLD in the allograft resulting in dissemination and death. The second case of PTLD developed in an EBV seropositive recipient who presented 33 months following LT with isolated colonic involvement. He subsequently died from chronic rejection.
The incidence of PTLD in a LT program with a large EBV seropositive population is low, 1.6%. The presentation of PTLD in LT recipients is variable and may present typically with allograft involvement in the first year following transplantation, or late with isolated, extrapulmonic involvement.
移植后淋巴组织增生性疾病（PTLD）可能是肺移植（LT）受者发病的重要原因。危险因素包括 Epstein-Barr 病毒（EBV）感染，尤其是原发性感染，以及免疫抑制。本文更新了我们肺移植项目中 PTLD 的发病率和表现。
我们回顾性分析了 129 例存活时间超过 1 个月的有风险的肺移植受者的免疫抑制情况、EBV 血清学及 PTLD 病例。
129 例 LT 患者中有 2 例发生 PTLD，2/129（1.6%）。其中 1 例患者是 6 例 EBV 血清学转换者之一，1/6（16.7%），其同种异体移植物中出现典型的 PTLD 表现，导致疾病播散和死亡。第二例 PTLD 发生在一名 EBV 血清学阳性的受者中，该受者在 LT 后 33 个月出现，仅累及结肠。他随后死于慢性排斥反应。
在 EBV 血清学阳性人群较多的 LT 项目中，PTLD 的发病率较低，为 1.6%。LT 受者中 PTLD 的表现各不相同，可能在移植后第一年典型地表现为同种异体移植物受累，或在后期表现为孤立的肺外受累。
