Primary sclerosing cholangitis and other risk factors for post-transplant lymphoproliferative disease after liver transplantation in adults
Copyright © 2023 American Association for the Study of Liver Diseases..
Post-transplant lymphoproliferative disease (PTLD) is a rare but serious complication of liver transplantation (LT) with morbidity and mortality. The risk factors for PTLD in adults are ill-defined. This study aimed to assess the risk factors for PTLD after LT in adults. All adult LT recipients between 1986 and 2016 from 2 centers in the Netherlands were included, with follow-up until 2020. PTLD was diagnosed according to the World Health Organization (WHO) classification. Potential risk factors for PTLD were assessed using multivariate Cox regression analysis. A total of 1281 patients were included, of whom 29 (2.3%) developed PTLD. Results show that independent risk factors for PTLD after LT in adults were no Epstein-Barr virus load monitoring strategy, primary sclerosing cholangitis as an indication for LT, era (historic era linked to more intense long-term immunosuppression), and Epstein-Barr virus-seronegative recipient. No other independent risk factors were identified in this study. Of the 207 patients with primary sclerosing cholangitis as an indication for LT, 13 (6.3%) developed PTLD versus 16 out of 1074 (1.5%) patients with other underlying liver diseases (log-rank p <0.001). The yearly PTLD incidence was higher in the first year than in the later years after LT (2.4%/y vs. 0.6%/y) for primary sclerosing cholangitis, but not for other indications (0.16%/y). In Epstein-Barr virus-seronegative recipients PTLD occurred earlier after LT, while in 97% of seropositive recipients it could occur very late after LT.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
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| Enthalten in: |
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society - (2023) vom: 13. Sept. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ruijter, Bastian N [VerfasserIn] |
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| Anmerkungen: |
Date Revised 05.10.2023 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1097/LVT.0000000000000256 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM361963165 |
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| 245 | 1 | 0 | |a Primary sclerosing cholangitis and other risk factors for post-transplant lymphoproliferative disease after liver transplantation in adults |
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| 500 | |a Date Revised 05.10.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2023 American Association for the Study of Liver Diseases. | ||
| 520 | |a Post-transplant lymphoproliferative disease (PTLD) is a rare but serious complication of liver transplantation (LT) with morbidity and mortality. The risk factors for PTLD in adults are ill-defined. This study aimed to assess the risk factors for PTLD after LT in adults. All adult LT recipients between 1986 and 2016 from 2 centers in the Netherlands were included, with follow-up until 2020. PTLD was diagnosed according to the World Health Organization (WHO) classification. Potential risk factors for PTLD were assessed using multivariate Cox regression analysis. A total of 1281 patients were included, of whom 29 (2.3%) developed PTLD. Results show that independent risk factors for PTLD after LT in adults were no Epstein-Barr virus load monitoring strategy, primary sclerosing cholangitis as an indication for LT, era (historic era linked to more intense long-term immunosuppression), and Epstein-Barr virus-seronegative recipient. No other independent risk factors were identified in this study. Of the 207 patients with primary sclerosing cholangitis as an indication for LT, 13 (6.3%) developed PTLD versus 16 out of 1074 (1.5%) patients with other underlying liver diseases (log-rank p <0.001). The yearly PTLD incidence was higher in the first year than in the later years after LT (2.4%/y vs. 0.6%/y) for primary sclerosing cholangitis, but not for other indications (0.16%/y). In Epstein-Barr virus-seronegative recipients PTLD occurred earlier after LT, while in 97% of seropositive recipients it could occur very late after LT | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Tushuizen, Maarten E |e verfasserin |4 aut | |
| 700 | 1 | |a van der Helm, Danny |e verfasserin |4 aut | |
| 700 | 1 | |a Hew, Mitchel |e verfasserin |4 aut | |
| 700 | 1 | |a Reeven, Marjolein |e verfasserin |4 aut | |
| 700 | 1 | |a Vossen, Ann C T M |e verfasserin |4 aut | |
| 700 | 1 | |a Metselaar, Herold J |e verfasserin |4 aut | |
| 700 | 1 | |a Alwayn, Ian P J |e verfasserin |4 aut | |
| 700 | 1 | |a Dubbeld, Jeroen |e verfasserin |4 aut | |
| 700 | 1 | |a Polak, Wojciech G |e verfasserin |4 aut | |
| 700 | 1 | |a van Hoek, Bart |e verfasserin |4 aut | |
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