Department of Transplantation and Vascular Surgery, Korea University College of Medicine, Seoul, South Korea.
Department of Kidney and Pancreas Transplantation Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
Asian J Surg. 2019 Apr;42(4):551-556. doi: 10.1016/j.asjsur.2018.09.002. Epub 2018 Oct 14.
The purpose of this study was to analyze the link between PTLD incidence and its occurrence time in patients at a single center in comparable medical environments after 2000.
Retrospectively, total 3305 kidney transplantation patients medical data were analyzed. Patients were divided into two groups based on the period from the day of kidney transplantation to the day of PTLD diagnosis. Early-onset was defined as PTLD development within two years after transplantation, whereas all other cases were categorized as late-onset PTLD.
In the early-onset group, young age (0-19 years) was confirmed as a risk factor for PTLD incidence (HR 1.49, p = 0.038). In the late-onset group, history of anti-rejection therapy was confirmed as a risk factor (HR 1.32, p = 0.031). Overall survival rates were not significantly different between the two groups (p = 0.556). Graft survival rates were also not different between the two groups (p = 0.549).
When patients with PTLD were classified into early-onset group and late-onset group at two years, overall survival and graft survival were comparable. And patients with early-onset PTLD are more likely to be associated with EBV, the late-onset patients are more likely to be immunosuppressed.
本研究旨在分析 2000 年后,在可比医疗环境下,单一中心患者中 PTLD 发病率及其发病时间之间的关系。
回顾性分析了 3305 例肾移植患者的医疗数据。根据从肾移植日到 PTLD 诊断日的时间,患者被分为两组。早期发病定义为移植后 2 年内发生 PTLD,而所有其他病例归类为晚期 PTLD。
在早期发病组中,年龄较小(0-19 岁)被确认为 PTLD 发病率的危险因素(HR 1.49,p=0.038)。在晚期发病组中,抗排斥治疗史被确认为危险因素(HR 1.32,p=0.031)。两组之间的总生存率无显著差异(p=0.556)。两组之间的移植物存活率也没有差异(p=0.549)。
当将 PTLD 患者分为两年内的早期发病组和晚期发病组时,总生存率和移植物生存率相当。而且,早期发病的患者更可能与 EBV 相关,晚期发病的患者更可能处于免疫抑制状态。