Heart failure & cardiomyopathiesCohort study
Temporal Trends, Risk Factors, and Clinical Outcomes of De Novo Lymphoproliferative Disorders After Heart Transplantation
- Retrospective registry cohort study
- multi-institutional
- multinational
- ISHLT Thoracic Organ Transplant Registry
Authors' conclusion
PTLD is relatively rare, but potentially fatal, post-transplant malignancy. PTLD incidence and mortality after HTx have decreased in the recent era.
Study context
- Population
- Heart transplant recipients, transplanted January 2000–June 2015
- Participants
- 28,136 recipients
Main finding
As reported in the abstract
PTLD within 10 years of transplantation · 10 years
Developed post-transplant lymphoproliferative disorder (PTLD) within 10 years
1,069 (3.8%)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Mortality with PTLD within 3 years | 2.42 (2.01–2.91) | P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
Risk factors for PTLD within 3 years
- Independent risk factors: early transplant era (2000-2007 vs 2008-2015), male recipient, EBV donor-positive-recipient-negative match
- Cyclosporine vs tacrolimus maintenance at initial discharge associated with lower incidence
- multivariable analysis
Survival after PTLD diagnosis
- Higher in the recent transplant era
Original publication
Temporal Trends, Risk Factors, and Clinical Outcomes of De Novo Lymphoproliferative Disorders After Heart Transplantation. JACC Heart Fail. doi:10.1016/j.jchf.2023.10.018
Summarised from the published abstract; every number is checked against it