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More Benign Lymphoproliferative Disease after Liver Transplant in Infants

Context Despite the high frequency of liver transplants in infants, few data are available on the characteristics of posttransplant lymphoproliferative disorders in liver transplant patients (PTLD). Objective To analyze special features and behavior of PTLD arising after liver transplant in infants. Methods A comprehensive search of the literature was conducted for the available data on PTLD in infant liver transplant recipients through PubMed and Google scholar. An infant was defined as a liver recipient who was less than 2 years old at the time of transplant. Overall, 205 cases of PTLD were found in 24 reports, and the 100 infants with PTLD were compared with children and adults with PTLD. Results PTLD lesions in infants were more likely to be polymorphic whereas monomorphic lesions were more prevalent among older patients (P= .05). Remission rates, metastasis frequency, and organ involvement did not differ significantly between the groups. Survival analysis showed that the infants had a significantly better outcome than did older patients (P = .05). Conclusion PTLD is more benign and may have a better outcome in infant liver transplant recipients than in older recipients. A prospective multicenter approach is needed for future research studies.