单位：[1]Liver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China临床科室国家中心普外分中心普外四科（肝脏移植外科）首都医科大学附属北京友谊医院[2]Intensive Care Unit, Beijing Friendship Hospital, Capital Medical University, Beijing, China临床科室急危重症及感染医学中心重症医学科首都医科大学附属北京友谊医院[3]Pathology Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China医技科室病理科病理科首都医科大学附属北京友谊医院[4]Nuclear Medicine Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China医技科室影像中心核医学科首都医科大学附属北京友谊医院
Objective The purpose of this study was to analyse the clinical and pathological characteristics, treatments and outcomes of post-transplant lymphoproliferative disorder (PTLD) in paediatric liver transplant recipients. Method A retrospective analysis of records from nine paediatric liver transplant recipients with PTLD who were treated at our Liver Transplant Center over the period from June 2013 to August 2018. Result Of these nine patients, seven received liver transplantation in our centre and the remaining two patients at other hospitals. The overall incidence of PTLD in paediatric liver transplant recipients in our centre was 1.4% (7/485). The median onset of PTLD after liver transplantation was 11 months. Three cases were classified as infectious mononucleosis PTLD, one case was plasmacytic hyperplasia PTLD, one case was polymorphic PTLD and two cases were Burkitt lymphoma. One case showed diffuse large B-cell lymphoma and one was classical Hodgkin lymphoma-like PTLD. These patients presented with different clinical manifestations including fever, anaemia, diarrhoea, hypoproteinaemia, enlargement of lymph nodes, hepatosplenomegaly, jaundice, bowel obstruction and even intestinal perforation. Nine patients were positive for EBV-DNA in serum. After diagnosis, immunosuppressants were reduced or discontinued in all cases. Eight patients received anti-CD20 monoclonal antibody (Rituximab) therapy, four cases were treated with a combination of chemotherapy (R-CHOP, ABVD, COPP/ABV) and one case was combined with radiotherapy. Two cases received surgical treatment due to bowel obstruction. Eight of these patients achieved a complete remission and remained healthy when assessed at the time of final follow-up. One patient died as a result of PTLD progression. Conclusion PTLD is one of the most serious and fatal complications after liver transplantation. The definitive diagnosis requires histopathology. Treatment varies and basically includes immunosuppression reduction, anti-CD20 antibody, surgery, radiotherapy and chemotherapy.
基金：
Beijing Municipal Science & Technology CommissionBeijing Municipal Science & Technology Commission [Z181100001718220]
第一作者单位：[1]Liver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
通讯作者：
通讯机构：[2]Intensive Care Unit, Beijing Friendship Hospital, Capital Medical University, Beijing, China[*1]Intensive Care Unit, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Road, Beijing, 100050, China
推荐引用方式(GB/T 7714)：
Liu Ying,Sun Li-Ying,Zhu Zhi-Jun,et al.Post-transplant lymphoproliferative disorder after paediatric liver transplantation[J].INTERNATIONAL JOURNAL of CLINICAL PRACTICE.2021,75(4):doi:10.1111/ijcp.13843.
APA：
Liu Ying,Sun Li-Ying,Zhu Zhi-Jun,Wei Lin,Qu Wei...&Zeng Zhi-Gui.(2021).Post-transplant lymphoproliferative disorder after paediatric liver transplantation.INTERNATIONAL JOURNAL of CLINICAL PRACTICE,75,(4)
MLA：
Liu Ying,et al."Post-transplant lymphoproliferative disorder after paediatric liver transplantation".INTERNATIONAL JOURNAL of CLINICAL PRACTICE 75..4(2021)
