Open AccessSurgical Management of Perforated Gastrointestinal Posttransplantation Lymphoproliferative Disorder After Heart Transplantation
Author(s) -
Hideki Osawa,
Mamoru Uemura,
Junichi Nishimura,
Taishi Hata,
Ichiro Takemasa,
Tsunekazu Mizushima,
Hirofumi Yamamoto,
Yuichiro� Doki,
Masaki Mori
Publication year - 2015
Publication title -
international surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.132
H-Index - 39
eISSN - 2520-2456
pISSN - 0020-8868
DOI - 10.9738/intsurg-d-13-00270.1
Subject(s) - medicine , transplantation , perforation , complication , surgery , heart transplantation , post transplant lymphoproliferative disorder , organ transplantation , lymphoproliferative disorders , epstein–barr virus , virus , lymphoma , immunology , metallurgy , punching , materials science
Posttransplantation lymphoproliferative disorder (PTLD) is a relatively rare and life-threatening complication after organ transplantation. From 1999 to 2012, 45 adult patients underwent heart transplantation at our hospital. Two of the patients developed PTLD after transplantation and required emergency surgery due to intestinal perforation. These cases were informative regarding the adequate surgical management of such cases. Both cases revealed Epstein-Barr virus-related PTLD. The optimal treatment of PTLD remains controversial, and PTLD with gastrointestinal perforation could be critical because the patients are already debilitated and immunocompromised after transplantation. Therefore, the nonspecific abdominal symptoms can be diagnostic for PTLD, and proper surgical intervention should be performed immediately. We present these two suggestive and rare cases in regard to the management of perforation with PTLD and a review of literature.
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