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Comparison of Post-Transplantation Lymphoproliferative Disorder Risk and Prognostic Factors between Kidney and Liver Transplant Recipients

SIMPLE SUMMARY: Organ graft type is an independent risk factor for the development of PTLD. Due to small cohort sizes caused by the rarity of the disease, most studies and trials are performed on populations of recipients of various organ graft types. Our study is a first direct comparison of the ef...

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Autores principales: Mucha, Krzysztof, Staros, Rafał, Foroncewicz, Bartosz, Ziarkiewicz-Wróblewska, Bogna, Kosieradzki, Maciej, Nazarewski, Sławomir, Naumnik, Beata, Raszeja-Wyszomirska, Joanna, Zieniewicz, Krzysztof, Pączek, Leszek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9024969/
https://www.ncbi.nlm.nih.gov/pubmed/35454860
http://dx.doi.org/10.3390/cancers14081953
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author Mucha, Krzysztof
Staros, Rafał
Foroncewicz, Bartosz
Ziarkiewicz-Wróblewska, Bogna
Kosieradzki, Maciej
Nazarewski, Sławomir
Naumnik, Beata
Raszeja-Wyszomirska, Joanna
Zieniewicz, Krzysztof
Pączek, Leszek
author_facet Mucha, Krzysztof
Staros, Rafał
Foroncewicz, Bartosz
Ziarkiewicz-Wróblewska, Bogna
Kosieradzki, Maciej
Nazarewski, Sławomir
Naumnik, Beata
Raszeja-Wyszomirska, Joanna
Zieniewicz, Krzysztof
Pączek, Leszek
author_sort Mucha, Krzysztof
collection PubMed
description SIMPLE SUMMARY: Organ graft type is an independent risk factor for the development of PTLD. Due to small cohort sizes caused by the rarity of the disease, most studies and trials are performed on populations of recipients of various organ graft types. Our study is a first direct comparison of the effect of different risk and prognostic factors between kidney and liver transplant recipients (KTRs and LTRs, respectively). We have demonstrated that the analysis of risk factors based on the general solid organ transplant recipient population is inconsistent with the results obtained through the analysis of single organ graft type cohorts. The risk of PTLD is lower in KTRs who are female, <45 years old at transplantation, or treated with cyclosporin. Based upon our findings, we are confident that the type of organ graft is an overriding factor in PTLDs’ development and course. ABSTRACT: Post-transplantation lymphoproliferative disorder (PTLD) is a life-threatening complication of solid organ transplantation (SOT). Its development risk varies among organ graft recipients. In this study, retrospective data were analyzed to compare PTLD’s risk and prognostic factors between adult kidney and liver transplant recipients (KTRs and LTRs, respectively). Over 15 years, 2598 KTRs and 1378 LTRs were under observation at our center. Sixteen KTRs (0.62%) and twenty-three LTRs (1.67%) were diagnosed with PTLD. PTLD developed earlier in LTRs (p < 0.001), SOT patients > 45 years old (p = 0.002), and patients receiving tacrolimus (p < 0.001) or not receiving cyclosporin (p = 0.03) at diagnosis. Tacrolimus use, male sex, and age > 45 years old significantly affected the time of PTLD onset in KTRs (hazard ratio (HR) = 18.6, 7.9 and 5.2, respectively). Survival was longer in LTRs < 45 years old (p < 0.009). LTRs were more likely than KTRs to achieve complete remission (p = 0.039). Factors affecting PTLD development and outcome differ between KTRs and LTRs; thus, these populations should be separately evaluated in future studies.
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spelling pubmed-90249692022-04-23 Comparison of Post-Transplantation Lymphoproliferative Disorder Risk and Prognostic Factors between Kidney and Liver Transplant Recipients Mucha, Krzysztof Staros, Rafał Foroncewicz, Bartosz Ziarkiewicz-Wróblewska, Bogna Kosieradzki, Maciej Nazarewski, Sławomir Naumnik, Beata Raszeja-Wyszomirska, Joanna Zieniewicz, Krzysztof Pączek, Leszek Cancers (Basel) Article SIMPLE SUMMARY: Organ graft type is an independent risk factor for the development of PTLD. Due to small cohort sizes caused by the rarity of the disease, most studies and trials are performed on populations of recipients of various organ graft types. Our study is a first direct comparison of the effect of different risk and prognostic factors between kidney and liver transplant recipients (KTRs and LTRs, respectively). We have demonstrated that the analysis of risk factors based on the general solid organ transplant recipient population is inconsistent with the results obtained through the analysis of single organ graft type cohorts. The risk of PTLD is lower in KTRs who are female, <45 years old at transplantation, or treated with cyclosporin. Based upon our findings, we are confident that the type of organ graft is an overriding factor in PTLDs’ development and course. ABSTRACT: Post-transplantation lymphoproliferative disorder (PTLD) is a life-threatening complication of solid organ transplantation (SOT). Its development risk varies among organ graft recipients. In this study, retrospective data were analyzed to compare PTLD’s risk and prognostic factors between adult kidney and liver transplant recipients (KTRs and LTRs, respectively). Over 15 years, 2598 KTRs and 1378 LTRs were under observation at our center. Sixteen KTRs (0.62%) and twenty-three LTRs (1.67%) were diagnosed with PTLD. PTLD developed earlier in LTRs (p < 0.001), SOT patients > 45 years old (p = 0.002), and patients receiving tacrolimus (p < 0.001) or not receiving cyclosporin (p = 0.03) at diagnosis. Tacrolimus use, male sex, and age > 45 years old significantly affected the time of PTLD onset in KTRs (hazard ratio (HR) = 18.6, 7.9 and 5.2, respectively). Survival was longer in LTRs < 45 years old (p < 0.009). LTRs were more likely than KTRs to achieve complete remission (p = 0.039). Factors affecting PTLD development and outcome differ between KTRs and LTRs; thus, these populations should be separately evaluated in future studies. MDPI 2022-04-13 /pmc/articles/PMC9024969/ /pubmed/35454860 http://dx.doi.org/10.3390/cancers14081953 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mucha, Krzysztof
Staros, Rafał
Foroncewicz, Bartosz
Ziarkiewicz-Wróblewska, Bogna
Kosieradzki, Maciej
Nazarewski, Sławomir
Naumnik, Beata
Raszeja-Wyszomirska, Joanna
Zieniewicz, Krzysztof
Pączek, Leszek
Comparison of Post-Transplantation Lymphoproliferative Disorder Risk and Prognostic Factors between Kidney and Liver Transplant Recipients
title Comparison of Post-Transplantation Lymphoproliferative Disorder Risk and Prognostic Factors between Kidney and Liver Transplant Recipients
title_full Comparison of Post-Transplantation Lymphoproliferative Disorder Risk and Prognostic Factors between Kidney and Liver Transplant Recipients
title_fullStr Comparison of Post-Transplantation Lymphoproliferative Disorder Risk and Prognostic Factors between Kidney and Liver Transplant Recipients
title_full_unstemmed Comparison of Post-Transplantation Lymphoproliferative Disorder Risk and Prognostic Factors between Kidney and Liver Transplant Recipients
title_short Comparison of Post-Transplantation Lymphoproliferative Disorder Risk and Prognostic Factors between Kidney and Liver Transplant Recipients
title_sort comparison of post-transplantation lymphoproliferative disorder risk and prognostic factors between kidney and liver transplant recipients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9024969/
https://www.ncbi.nlm.nih.gov/pubmed/35454860
http://dx.doi.org/10.3390/cancers14081953
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