Incidence and Clinical Outcomes of Post-Transplant Lymphoproliferative Disorder (PTLD) in Lung Transplant Recipients

Title: Incidence and Clinical Outcomes of Post-Transplant Lymphoproliferative Disorder (PTLD) in Lung Transplant Recipients
Author(s): Boyle N, Winward S, Lawrie I, Towell S, Egan J, Ronan N, Murray M
Institution: Mater Misercordiae University Hospital
Poster: Click to view poster
Category: General Respiratory and Sleep
Abstract: PTLD is a complication of transplantation with significant morbidity and mortality1. Incidence varies with age, transplant type and immunosuppression2. We aimed to examine the incidence and PTLD outcomes in lung transplant recipients.

A retrospective review of lung transplant recipients in the National Lung Transplant Unit between 2005 and 2020 was undertaken to identify patients with PTLD.

From 297 recipients, 8 (7 males, 1 female) were diagnosed with PTLD (2.69%). Indications for transplant were cystic fibrosis (n=5, 62%), sarcoid (n=2, 25%) and emphysema (n=1, 12.5%). Median age at transplant was 30. Median time from transplant to PTLD was 10.53 months. Median age at diagnosis was 35. All were on immunosuppression at the time of diagnosis. The majority had monomorphic PTLD (n=5 Diffuse Large B-Cell, n=1 Burkitt, n=2 polymorphic). 37.5% had bone marrow involvement. 25% had central nervous system involvement. Immunosuppression was reduced in all. 75% received rituximab, 37% received chemotherapy (n=1 R-epoch, n=2 R-chop), 12% received radiotherapy and 1 died prior to treatment. One-year survival was 62.5%. One experienced recurrence at 21-months.

This highlights the incidence and outcomes of PTLD in lung transplant recipients in Ireland which are in keeping with international studies1,2.