Kalinova Lucie, Indrakova Jarmila, Bachleda Petr
Department of Surgery II, University Hospital, I. P. Pavlova 6, Olomouc, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2009 Dec;153(4):251-7. doi: 10.5507/bp.2009.043.
Posttransplant lymphoproliferative disorder (PTLD) is increasingly recognized as a serious complication of solid organ transplantation in both children and adults. Factors associated with increased risk of PTLD include mismatch of recipient and donor EBV serologic status (seronegative recipient with seropositive donor), and intensive drug-induced immunosuppression.
We searched MEDLINE for articles published since 1970 to January 2009. Search terms included posttransplant lymphoproliferative disorder, immunosuppression, posttransplant malignancy, treatment, antiviral agents, rituximab, interferon alpha, chemotherapy, radiation, surgery. Studies in English of adult and pediatric populations after solid organ transplantation were selected and analyzed.
Screening of patients at risk and balancing the intensity of immunosuppression against the risk of allograft rejection could reduce the risk of developing PTLD. In patients who develop PTLD, the severity and extent of disease should be examined and an individualized treatment plan including immunosuppression reduction and other agents should accordingly be chosen.
移植后淋巴细胞增生性疾病（PTLD）日益被认为是儿童和成人实体器官移植的一种严重并发症。与PTLD风险增加相关的因素包括受者和供者EBV血清学状态不匹配（血清阴性受者与血清阳性供者），以及强化药物诱导的免疫抑制。
我们检索了MEDLINE中自1970年至2009年1月发表的文章。检索词包括移植后淋巴细胞增生性疾病、免疫抑制、移植后恶性肿瘤、治疗、抗病毒药物、利妥昔单抗、干扰素α、化疗、放疗、手术。选择并分析了关于实体器官移植后成人和儿童人群的英文研究。
对有风险的患者进行筛查，并在免疫抑制强度与同种异体移植排斥风险之间取得平衡，可以降低发生PTLD的风险。对于发生PTLD的患者，应检查疾病的严重程度和范围，并相应地选择包括降低免疫抑制及其他药物的个体化治疗方案。
