Surgical management of perforated gastrointestinal posttransplantation lymphoproliferative disorder after heart transplantation

Hideki Osawa, Mamoru Uemura, Junichi Nishimura, Taishi Hata, Ichiro Takemasa, Tsunekazu Mizushima, Hirofumi Yamamoto, Yuichiro Doki, Masaki Mori

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3 Citations (Scopus)

Abstract

Posttransplantation lymphoproliferative disorder (PTLD) is a relatively rare and lifethreatening 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.

Original languageEnglish
Pages (from-to)358-364
Number of pages7
JournalInternational Surgery
Volume100
Issue number2
DOIs
Publication statusPublished - Feb 2015
Externally publishedYes

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All Science Journal Classification (ASJC) codes

  • Surgery

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