Mucha Krzysztof, Staros Rafał, Foroncewicz Bartosz, Ziarkiewicz-Wróblewska Bogna, Kosieradzki Maciej, Nazarewski Sławomir, Naumnik Beata, Raszeja-Wyszomirska Joanna, Zieniewicz Krzysztof, Pączek Leszek
Department of Immunology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-006 Warsaw, Poland.
Institute of Biochemistry and Biophysics, Polish Academy of Sciences, 02-106 Warsaw, Poland.
Cancers (Basel). 2022 Apr 13;14(8):1953. doi: 10.3390/cancers14081953.
Post-transplantation lymphoproliferative disorder (PTLD) is a life-threatening complication of solid organ transplantation (SOT). Its development risk varies among organ graft recipients. In this study, retrospective data were analyzed to compare PTLD’s risk and prognostic factors between adult kidney and liver transplant recipients (KTRs and LTRs, respectively). Over 15 years, 2598 KTRs and 1378 LTRs were under observation at our center. Sixteen KTRs (0.62%) and twenty-three LTRs (1.67%) were diagnosed with PTLD. PTLD developed earlier in LTRs (p < 0.001), SOT patients > 45 years old (p = 0.002), and patients receiving tacrolimus (p < 0.001) or not receiving cyclosporin (p = 0.03) at diagnosis. Tacrolimus use, male sex, and age > 45 years old significantly affected the time of PTLD onset in KTRs (hazard ratio (HR) = 18.6, 7.9 and 5.2, respectively). Survival was longer in LTRs < 45 years old (p < 0.009). LTRs were more likely than KTRs to achieve complete remission (p = 0.039). Factors affecting PTLD development and outcome differ between KTRs and LTRs; thus, these populations should be separately evaluated in future studies.
移植后淋巴细胞增生性疾病（PTLD）是实体器官移植（SOT）的一种危及生命的并发症。其发生风险在器官移植受者中各不相同。在本研究中，分析回顾性数据以比较成年肾移植受者和肝移植受者（分别为KTRs和LTRs）中PTLD的风险及预后因素。在15年多的时间里，本中心观察了2598例KTRs和1378例LTRs。16例KTRs（0.62%）和23例LTRs（1.67%）被诊断为PTLD。PTLD在LTRs中出现得更早（p<0.001），在年龄>45岁的SOT患者中出现得更早（p = 0.002），且在诊断时使用他克莫司的患者中出现得更早（p<0.001）或未接受环孢素的患者中出现得更早（p = 0.03）。使用他克莫司、男性性别以及年龄>45岁显著影响KTRs中PTLD的发病时间（风险比（HR）分别为18.6、7.9和5.2）。年龄<45岁的LTRs生存率更长（p<0.009）。LTRs比KTRs更有可能实现完全缓解（p = 0.039）。影响PTLD发生和结局的因素在KTRs和LTRs之间有所不同；因此，在未来的研究中应对这些人群进行分别评估。
