Comparison of Post-Transplantation Lymphoproliferative Disorder Risk and Prognostic Factors between Kidney and Liver Transplant Recipients

Abstract

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.

Characterization and outcome of post-transplant lymphoproliferative disorders within a collaborative study

“…This is corroborated by the fact that almost all patients of the allo-HSCT group were still on immunosuppressive therapy at the time of PTLD diagnosis. Tailored maintenance immunosuppressive regimens, however, may help to reduce the risk of PTLD onset (19).…”

Perspectives for 3D-Bioprinting in Modeling of Tumor Immune Evasion

“…A successful non-bioprinted 3D spheroid model of imunocompetent DLBCL cocultured with ADSCs devised by Foxall et al [101] confirms the relevance of aggressive lymphoma culture in solid environments. Potential PTLD models would serve only as an approximation of lymphomas in the immunocompetent, as the mechanisms driving the development of malignancy are different from their immunocompetent counterparts-PTLD's development is more frequently associated with the Epstein-Barr virus (EBV) infection, decreased immune surveillance due to immunosuppression, chronic inflammation, and immune exhaustion [102,103].…”