Background: It is speculated that different localizations of lymphoproliferative disorder after solid organ transplantation (PTLD) have different features and represent specific behavior as well as prognostic individualities.
Objectives: To compare characteristics of hepatic PTLD (H-PTLD) with non-hepatic PTLD (NH-PTLD) in liver transplant recipients.
Materials and methods: We searched PubMed and Google Scholar for all published reports of PTLD in liver recipients within their liver. Reported characteristics of H-PTLD and NH-PTLD were compared.
Results: A total of 21 studies from various countries were found. Overall, 169 liver recipients with PTLD were included in the analysis, of whom 83 (49%) had H-PTLD. Patients with H-PTLD were more likely to test positive for Epstein-Barr virus (EBV) (p < 0.0001), be older at the time of transplantation (p = 0.009), have a shorter time to PTLD development (80 vs. 41% early-onset PTLD; p < 0.001), and have bone marrow involvement (p = 0.03). Multivariate linear regression showed that H-PTLD and EBV positivity, but not age at transplant, were independently associated with time to PTLD development (p = 0.003, p < 0.0001, and p = 1.0, respectively).
Conclusions: Liver transplant patients exhibiting early deterioration of graft function or other hepatic symptoms should, in addition to assessment for rejection, be evaluated for H-PTLD. In addition, all H-PTLD patients should be evaluated for bone marrow involvement, especially if they are EBV positive. Prospective studies with large patient populations are needed to confirm our results.