1. Post-transplant lymphoproliferative disorder after liver transplantation: Incidence, long-term survival and impact of serum tacrolimus level.
- Author
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Eshraghian A, Imanieh MH, Dehghani SM, Nikeghbalian S, Shamsaeefar A, Barshans F, Kazemi K, Geramizadeh B, and Malek-Hosseini SA
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Immunosuppressive Agents therapeutic use, Incidence, Iran, Kaplan-Meier Estimate, Lymphoproliferative Disorders epidemiology, Male, Postoperative Complications, Regression Analysis, Risk Factors, Sensitivity and Specificity, Treatment Outcome, Liver Failure surgery, Liver Transplantation adverse effects, Lymphoproliferative Disorders etiology, Tacrolimus blood
- Abstract
Aim: To investigate incidence and survival of post-transplant lymphoproliferative disorder (PTLD) patients after liver transplantation., Methods: A cross-sectional survey was conducted among patients who underwent liver transplantation at Shiraz Transplant Center (Shiraz, Iran) between August 2004 and March 2015. Clinical and laboratory data of patients were collected using a data gathering form., Results: There were 40 cases of PTLD in the pediatric age group and 13 cases in the adult group. The incidence of PTLD was 6.25% in pediatric patients and 1.18% in adult liver transplant recipients. The post-PTLD survival of patients at 6 mo was 75.1% ± 6%, at 1 year was 68.9% ± 6.5% and at 5 years was 39.2% ± 14.2%. Higher serum tacrolimus level was associated with lower post-PTLD survival in pediatric patients (OR = 1.07, 95%CI: 1.006-1.15, P = 0.032). A serum tacrolimus level over 11.1 ng/mL was predictive of post PTLD survival (sensitivity = 90%, specificity = 52%, area under the curve = 0.738, P = 0.035)., Conclusion: Incidence of PTLD in our liver transplant patients is comparable to other centers. Transplant physicians may consider adjustment of tacrolimus dose to maintain its serum level below this cutoff point., Competing Interests: Conflict-of-interest statement: The authors have no conflict of interest. The study was supported by a grant from Shiraz University of Medical Sciences.
- Published
- 2017
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