Surgical Management of Gastrointestinal Posttransplant Lymphoproliferative Disorders in Liver Transplant Recipients

• DOI: 10.1097/tp.0b013e3182584854
• Publication Date: 2012-07-20T19:15:10Z
• Authors: Ruy J. Cruz; Sumana Ramachandra; Eisaburo Sasatomi; Andrea DiMartini; Michael de Vera; Paulo Fontes; Christopher Hughes; Abhinav Humar
• Keywords: Immunosuppression; Perforation

Posttransplant lymphoproliferative disorder (PTLD) is a well-established complication of immunosuppression. The involvement the gastrointestinal (GI) tract occurs in 25% all cases PTLD. Fortunately, surgical intervention seldom required. We report our experience treatment complicated GI-PTLD after liver transplantation (LTx).A retrospective analysis 5677 adult patients who underwent LTx between 1983 and 2009 was conducted.Thirty-six presented with GI-PTLD. Sixteen complications associated requiring emergency surgery. average (SD) time from to GI surgery 7.9 (5.8) years (range, 4 months 17 years). Indications for were small bowel obstruction (seven cases), perforation (six bleeding (three cases). Most occurred or right colon (81%). In addition surgery, PTLD consisted reduction immunosuppression, use rituximab (n=10), systemic chemotherapy (n=7). Overall mortality 69%, most deaths occurring within 8 laparotomy. higher (>66%). Despite early group, no differences on long-term outcome observed required those did not (P=0.371).In summary, an extremely rare condition high mortality. are monoclonal, present late onset, involve lower tract. Intestinal main indication better prognosis.