Adult post-transplant lymphoproliferative disease in the liver graft in patients with recurrent hepatitis C

Aim The aim of this study is to clarify the association between hepatitis C virus (HCV) infection and post-transplant lymphoproliferative disease (PTLD) in the liver allograft. Methods Of the 933 adults who underwent liver transplantation (LT) between 1990 and 2005, 10 patients developed PTLD. Seven of the 10 patients that were HCV(+) (group 1) were compared with three HCV-negative recipients (group 2). Results The mean time between LT and PTLD was 24.5 months. There were no differences between in Epstein-Barr virus antibody status or tumor lymphocyte subsets. In five of the seven HCV-positive recipients who developed PTLD, PTLD recurred preferentially in the liver allograft, whereas none of the three HCV-negative patients who developed PTLD did so in the liver (71.4 vs. 0%, respectively, P = 0.038). In all five patients with graft PTLD, HCV recurred within 12 months followed by PTLD. There were significant differences between groups 1 and 2 in mean lymphocyte infiltrate scores (6.0 +/- 2.1 vs. 2.0 +/- 0.7, P = 0.037), fibrosis stage (2.4 +/- 0.5 vs. 0.7 +/- 0.5, P = 0.029), and frequency of lymphoid follicles in portal areas (33.6 +/- 14.8% vs. 1.1 +/- 2.3%, P = 0.0002). Conclusion When PTLD occurs in patients with HCV recurrence after LT, it does so preferentially in the liver allograft. Eur J Gastroenterol Hepatol 23:559-565 (c) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.