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Post-transplant lymphoproliferative disorder (PTLD) is a serious and potentially fatal complication of solid organ transplantation. It is the commonest malignancy in this population (excluding non melanoma skin cancer and in situ cervical cancer), accounting for 10 percent of all malignancies. The overall risk of PTLD in SOT recipients is between 1 and 2%. Extra nodal involvement is common, occurring in approximately 30 to 70 percent of cases of PTLD. Hepatic involvement typically occurs as part of extra nodal involvement and may also rarely present as localized hepatic lymphoma. The highest incidence of lymphoma occurs during the first year, cumulative risk increases in subse quent years and at 10 years the relative risk is 11.8-fold, compared with that of the nontransplant population. The aetiology appears to be related to B cell proliferation induced by infection with Epstein-Barr virus (EBV) in the setting of chronic immunosuppression resulting in a deficiency of EBV-specific cytotoxic T lymphocytes (CTL). Predisposing factors include EBV mismatch between donor and recipient, use of immunosuppression especially T-cell depletive therapies and genetic predisposition of recipients. Hepatitis B virus (HBV) reactivation has been suggested as a risk factor for non-Hodgkin’s lymphoma.

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2010-05-11   |   660 visitas   |   Evalua este artículo 0 valoraciones

Vol. 9 Núm.1. Enero-Marzo 2010 Pags. 91-92 Ann Hepatol 2010; 9(1)