Nephrology and Transplantation Service, Hôpital Saint-Louis, Paris, France.
Transplantation. 2012 Oct 27;94(8):784-93. doi: 10.1097/TP.0b013e318269e64f.
: Posttransplant lymphoproliferative disorders (PTLDs) are associated with significant morbidity and mortality among solid-organ transplant patients, but approaches to diagnosis and management vary considerably. An international multidisciplinary panel evaluated current understanding of risk factors and classification systems and developed recommendations to aid in PTLD prevention. We considered evidence on PTLD risk factors including Epstein-Barr virus serostatus and immunosuppression and identified knowledge gaps for future research. Recommendations address prophylactic and preemptive strategies to minimize PTLD development, including modulation of immunosuppression and antiviral drug regimens. Finally, new classification criteria were outlined that may help facilitate standardized reporting and improve our understanding of PTLD.
移植后淋巴组织增生性疾病(PTLD)与实体器官移植患者的发病率和死亡率显著相关,但诊断和管理方法差异很大。一个国际多学科小组评估了当前对风险因素和分类系统的认识,并提出了建议,以帮助预防 PTLD。我们考虑了 PTLD 风险因素的证据,包括 EBV 血清状态和免疫抑制,并确定了未来研究的知识空白。建议包括预防和先发制人的策略,以尽量减少 PTLD 的发展,包括免疫抑制和抗病毒药物方案的调整。最后,概述了新的分类标准,这可能有助于促进标准化报告,并提高我们对 PTLD 的理解。