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肾移植受者的移植后淋巴细胞增生性疾病:日本单中心经验

Post-Transplant Lymphoproliferative Disorder in Kidney Transplant Recipients: A Single-Center Experience in Japan.

作者信息

Ishihara Hiroki, Shimizu Tomokazu, Unagami Kohei, Hirai Toshihito, Toki Daisuke, Omoto Kazuya, Okumi Masayoshi, Imai Yoichi, Ishida Hideki, Tanabe Kazunari

机构信息

Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.

Department of Urology, Toda-Cho General Hospital, Saitama, Japan.

出版信息

Ther Apher Dial. 2016 Apr;20(2):165-73. doi: 10.1111/1744-9987.12392. Epub 2016 Mar 7.

Abstract

Post-transplant lymphoproliferative disorder is a serious complication of solid organ transplantation; however, few large studies have been performed in Asian institutions. We review our single-center experience with post-transplant lymphoproliferative disorder patients in Japan. We retrospectively evaluated patients with post-transplant lymphoproliferative disorder following kidney transplantation between January 1985 and December 2013. The patients were divided into early-onset post-transplant lymphoproliferative disorder (<1 year) and late-onset post-transplant lymphoproliferative disorder (≥1 year) groups. Thirteen patients had the disorder, an incidence rate of 0.75% (13/1730). Early-onset post-transplant lymphoproliferative disorder (N = 3) had not occurred for the last two decades. In the late-onset group (N = 10), the median time of onset was 108.7 months. The Kaplan-Meier 10-year overall survival rates were 76.9% and 95.4% in patients with and without the disorder, respectively (P = 0.0001). Post-transplant lymphoproliferative disorder significantly affected transplant recipients' mortality. Late-onset occurred even > 10 years after transplantation; therefore, long-term monitoring of patients is needed.

摘要

移植后淋巴组织增生性疾病是实体器官移植的一种严重并发症;然而,亚洲机构开展的大型研究较少。我们回顾了我们在日本对移植后淋巴组织增生性疾病患者的单中心经验。我们回顾性评估了1985年1月至2013年12月期间肾移植后患有移植后淋巴组织增生性疾病的患者。患者被分为早发型移植后淋巴组织增生性疾病(<1年)和晚发型移植后淋巴组织增生性疾病(≥1年)组。13例患者患有该疾病,发病率为0.75%(13/1730)。早发型移植后淋巴组织增生性疾病(N = 3)在过去二十年中未发生。在晚发型组(N = 10)中,发病的中位时间为108.7个月。有和没有该疾病的患者的Kaplan-Meier 10年总生存率分别为76.9%和95.4%(P = 0.0001)。移植后淋巴组织增生性疾病显著影响移植受者的死亡率。晚发型甚至在移植后>10年发生;因此,需要对患者进行长期监测。

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