Diagnosis and treatment of liver-localized lymphoproliferative disease following liver transplantation
10.3760/cma.j.issn.0254-1785.2012.11.010
- VernacularTitle:肝移植术后肝脏局部淋巴细胞增生性疾病的诊断和治疗
- Author:
Ranran JIANG
;
Jianjun ZHANG
;
Zhijun ZHU
;
Hong ZHENG
;
Yonglin DENG
;
Cheng PAN
- Publication Type:Journal Article
- Keywords:
Liver transplantation;
Lymphoproliferative disorders;
Diagnosis;
Therapy
- From:
Chinese Journal of Organ Transplantation
2012;(11):676-679
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical diagnosis and treatment strategies of liver-localized posttransplantation lymphoproliferative disease (LL-PTLD).Methods Six cases of LL-PTLD from more than 3000 cases of liver transplant recipients from July 2003 to July 2011 were retrospectively analyzed.Other six cases of LL-PTLD were retrieved through Pubmed and Wanfang.The diagnosis and treatment of 12 cases of LL-PTLD were summarized and analyzed.Results All patients with LL-PTLD were diagnosed pathologically.The incidence of LL-PTLD was 0.2％ (6/3000).Among 12 patients,immunosuppressant and anti-EB virus treatment was reduced or withdrawn in the vast majority of patients,and treatment response was satisfactory.Systemic chemotherapy was given in 6 cases,and three of them died.Local radiation therapy was given in 4 cases,the tumor was significantly controled,and patients survived.Secondary liver transplantation was performed on 3 cases: 1 case died of recurrent lymphoma,and one case received partial hepatectomy and no lymphoma recurred.Conclusion For cases with obstructive symptoms of fever and chills associated with jaundice without reasonable explanation,LL-PTLD is suspected and diagnosed by liver biopsy.Basic treatments such as adjustment of immunosuppressive agents and anti-viral therapy are recommended as early as possible.Local radiation therapy is a treatment method of LL-PTLD,which can obtain a satisfactory therapeutic effect.
