Details

Autor(en) / Beteiligte

• Leyssens, Annelies
• Dierickx, Daan
• Verbeken, Eric K.
• Tousseyn, Thomas
• Verleden, Stijn E.
• Vanaudenaerde, Bart M.
• Dupont, Lieven J.
• Yserbyt, Jonas
• Verleden, Geert M.
• Van Raemdonck, Dirk E.
• Vos, Robin

Titel

Post‐transplant lymphoproliferative disease in lung transplantation: A nested case‐control study

Ist Teil von

• Clinical transplantation, 2017-07, Vol.31 (7), p.n/a

Ort / Verlag

Denmark

Erscheinungsjahr

2017

Quelle

MEDLINE

Beschreibungen/Notizen

• Post‐transplant lymphoproliferative disorder (PTLD) may compromise long‐term outcome of lung transplant (LTx) recipients. A case‐control study was performed, comparing LTx recipients with PTLD (n=31) to matched recipients without PTLD (Controls, n=62). Risk factors for PTLD and post‐transplant outcomes were assessed. PTLD prevalence was 3.9%, time to PTLD 323 (166‐1132) days; and 54.8% had early‐onset PTLD versus 45.2% late‐onset PTLD. At LTx, more Epstein‐Barr virus (EBV)‐seronegative patients were present in PTLD (42%) compared to Controls (5%) (P<.0001); most of whom had undergone EBV seroconversion upon PTLD diagnosis. EBV viral load was higher in PTLD versus Controls (P<.0001). Overall, lower hemoglobin and higher C‐reactive protein levels were present in PTLD versus Controls (P<.0001). EBV status at LTx (P=.0073) and EBV viral load at PTLD (P=.0002) were the most important risk determinates for later PTLD. Patients with PTLD demonstrated shorter time to onset of chronic lung allograft dysfunction (CLAD) (P=.0006) and poorer 5‐year survival post‐LTx (66.6% versus 91.5%), resulting in worse CLAD‐free survival (HR 2.127, 95%CI 1.006‐4.500; P=.0483) and overall survival (HR 3.297 95%CI 1.473‐7.382; P=.0037) compared to Controls. Late‐onset PTLD had worse survival compared to early‐onset PTLD (P=.021). Primary EBV infection is a risk for PTLD; which is associated with worse long‐term outcome post‐LTx.