Adult post-transplant lymphoproliferative disease in the liver graft in patients with recurrent hepatitis C

Eur J Gastroenterol Hepatol. 2011 Jul;23(7):559-65. doi: 10.1097/MEG.0b013e3283474ac9.

Abstract

Aim: The aim of this study is to clarify the association between hepatitis C virus (HCV) infection and post-transplant lymphoproliferative disease (PTLD) in the liver allograft.

Methods: Of the 933 adults who underwent liver transplantation (LT) between 1990 and 2005, 10 patients developed PTLD. Seven of the 10 patients that were HCV(+) (group 1) were compared with three HCV-negative recipients (group 2).

Results: The mean time between LT and PTLD was 24.5 months. There were no differences between in Epstein-Barr virus antibody status or tumor lymphocyte subsets. In five of the seven HCV-positive recipients who developed PTLD, PTLD recurred preferentially in the liver allograft, whereas none of the three HCV-negative patients who developed PTLD did so in the liver (71.4 vs. 0%, respectively, P=0.038). In all five patients with graft PTLD, HCV recurred within 12 months followed by PTLD. There were significant differences between groups 1 and 2 in mean lymphocyte infiltrate scores (6.0±2.1 vs. 2.0±0.7, P=0.037), fibrosis stage (2.4±0.5 vs. 0.7±0.5, P=0.029), and frequency of lymphoid follicles in portal areas (33.6±14.8% vs. 1.1±2.3%, P=0.0002).

Conclusion: When PTLD occurs in patients with HCV recurrence after LT, it does so preferentially in the liver allograft.

MeSH terms

  • Adolescent
  • Aged
  • Antibodies, Viral / blood
  • Azathioprine / therapeutic use
  • Cohort Studies
  • Cyclosporine / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Graft Rejection / drug therapy
  • Graft Rejection / immunology
  • Graft Rejection / virology
  • Hepatitis C / blood
  • Hepatitis C / complications*
  • Hepatitis C / immunology
  • Hepatitis C / virology
  • Herpesvirus 4, Human / immunology
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / immunology
  • Lymphoproliferative Disorders / blood
  • Lymphoproliferative Disorders / etiology*
  • Lymphoproliferative Disorders / immunology
  • Lymphoproliferative Disorders / virology
  • Male
  • Middle Aged
  • Mycophenolic Acid / analogs & derivatives
  • Mycophenolic Acid / therapeutic use
  • Postoperative Complications / drug therapy
  • Postoperative Complications / immunology
  • Postoperative Complications / virology
  • Steroids / therapeutic use
  • Tacrolimus / therapeutic use

Substances

  • Antibodies, Viral
  • Immunosuppressive Agents
  • Steroids
  • Cyclosporine
  • Mycophenolic Acid
  • Azathioprine
  • Tacrolimus