Malatack J F, Gartner J C, Urbach A H, Zitelli B J
Children's Hospital of Pittsburgh, University of Pittsburgh Health Science Center, PA 15213-2583.
J Pediatr. 1991 May;118(5):667-75. doi: 10.1016/s0022-3476(05)80024-1.
Lymphoproliferative disease (LPD) is a well-recognized complication of both solid organ and bone marrow transplantations. The occurrence of LPD in these settings is related in part to the use of the immunosuppressive agent cyclosporine. We report 12 cases of LPD after orthotopic liver transplantations in 132 pediatric patients. Lymphoproliferative disease occurred as one of three clinical syndromes: (1) lymphadenopathic, (2) systemic, and (3) lymphomatous. Effective management of LPD with excisional therapy or reduction of immunosuppressive medications or both resulted in the survival of 7 of 12 patients. In an alarming and increasing percentage of patients after orthotopic liver transplantation, progressive LPD develops with lethal outcome (5/12 patients). Early recognition of LPD and aggressive intervention may improve outcome in this group.
淋巴增殖性疾病（LPD）是实体器官移植和骨髓移植中一种公认的并发症。在这些情况下LPD的发生部分与免疫抑制剂环孢素的使用有关。我们报告了132例小儿原位肝移植术后发生LPD的12例病例。淋巴增殖性疾病表现为三种临床综合征之一：（1）淋巴结病型，（2）全身型，（3）淋巴瘤型。采用切除疗法或减少免疫抑制药物用量或两者兼用对LPD进行有效治疗，使得12例患者中的7例存活。在原位肝移植术后患者中，进展性LPD的发生率令人担忧且不断上升，会导致致命后果（12例患者中有5例）。早期识别LPD并积极干预可能会改善该组患者的预后。
