Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA.
Clin Transplant. 2011 Sep-Oct;25(5):705-13. doi: 10.1111/j.1399-0012.2010.01332.x. Epub 2010 Nov 16.
Post-transplant lymphoproliferative disorders (PTLD) are potentially fatal complications of solid organ transplantation. The natural history of PTLD varies considerably among the different types of organs transplanted. While lung transplant recipients are highly susceptible to PTLD, there are only a few small studies that detail PTLD in this setting. We undertook this study to better describe the characteristics and treatment response in PTLD after lung transplantation. We conducted a retrospective chart review of lung and heart/lung-transplant recipients between 1985 and 2008. A total of 32 cases (5%) of PTLD were identified in 639 patients. The median interval after transplantation to the diagnosis was 40 (3-242) months. Eight patients (25%) were diagnosed within one yr of transplantation and had PTLD predominantly within the thorax and allograft. Twenty-four patients (75%) were diagnosed more than one yr after transplantation and their tumors mainly affected the gastrointestinal tract. Monomorphic PTLD, diffuse large B-cell lymphoma, was diagnosed in 91%. Treatment of PTLD varied according to stage and clinical circumstances. Twenty-four patients (75%) have died. The median overall survival was 10 (0-108) months. PTLD after lung transplantation remains a challenge as a result of its frequency, complexity and disappointing outcome.
移植后淋巴组织增生性疾病（PTLD）是实体器官移植的潜在致命并发症。PTLD 的自然史在不同类型的移植器官中差异很大。虽然肺移植受者极易发生 PTLD，但仅有少数几项详细描述该情况下 PTLD 的小型研究。我们进行这项研究是为了更好地描述肺移植后 PTLD 的特征和治疗反应。我们对 1985 年至 2008 年间的肺和心肺移植受者进行了回顾性图表审查。在 639 例患者中，共发现 32 例（5%）PTLD。移植后诊断的中位间隔为 40（3-242）个月。8 例（25%）患者在移植后 1 年内被诊断出患有 PTLD，且主要累及胸部和移植物。24 例（75%）患者在移植后 1 年以上被诊断出患有 PTLD，其肿瘤主要影响胃肠道。91%的患者诊断为单形性 PTLD，弥漫性大 B 细胞淋巴瘤。PTLD 的治疗根据分期和临床情况而有所不同。24 例（75%）患者死亡。总生存中位数为 10（0-108）个月。由于其频率、复杂性和令人失望的结果，肺移植后的 PTLD 仍然是一个挑战。
