Gastrointestinal manifestations, risk factors, and management in patients with post-transplant lymphoproliferative disorder: A systematic review

Table 1 Study details

Ref.	Localization of PTLD	Time from transplant to PTLD (yr)	Classification
			Monomorphic	Polymorphic
Wozniak et al[17]	Small bowel: 9/19	7.4	9/19	10/19
	Colorectal: 3/19
	Liver: 2/19
Koo et al[14]	Small bowel: 11/12	2.7	1/12	8/12
	Colorectal: 1/12
Khedmat et al[13]	Stomach + small bowel: 13/45	4.1	23/39	13/39
	Stomach + pancreas: 3/45
	Stomach + liver: 7/45
	Stomach: 56/472
Khedmat et al[16]	Colorectal + liver: 10/73	4.1	36/57	18/57
	Colorectal + small bowel: 22/73
	Colorectal + stomach: 2/73
	Colorectal: 81/563
Cruz Jr et al[15]	Colorectal: 6/17	7.2	13/17	3/17
	Small bowel: 11/17
Ganne et al[18]	Small bowel: 1/8	4.8	0/2	2/2
	Stomach: 1/8

PTLD: Post-transplant lymphoproliferative disorder.

Table 2 Study details regarding gastrointestinal post-transplant lymphoproliferative disorder

Ref.	Noted findings regarding GI-PTLD
Plummer et al[11]	PTLD presentation is non-specific. Prognosis is variable dependent on burden of disease, age at the time of diagnosis, and morphological subtype
Small et al[7]	EBV infection is crucial in the pathophysiology of PTLD. EBV+ patients are more likely to respond to RIS. Chemotherapy can be utilized after RIS if RIS appears unsuccessful
Dako et al[12]	Imaging of PTLD involving GI tract is variable. Imaging of PTLD may appear as a large mass, luminal ulceration, intussusception, or soft tissue nodules
Wozniak et al[17]	Risk of acute cellular rejection increased when treatment for PTLD occurred. Notable risk factors for PTLD include chronic immunosuppression, viral infection, and increased time from transplantation
Koo et al[14]	Incidence rate of PTLD after small bowel transplantation was up to 50%
Khedmat et al[13]	Clinical presentation of PTLD is nonspecific. Early treatment with RIS, rituximab, chemotherapy, or surgical therapy, if indicated, can decrease mortality rates
Khedmat et al[16]	Patients with PTLD and colorectal symptoms were noted to have a higher risk of metastatic disease. Colorectal PTLD may occur more frequently and may be more aggressive in men compared to women. Multi-organ failure may be more common in men compared to women if there is colorectal PTLD
Cruz Jr et al[15]	Surgical intervention uncommonly required for PTLD. Most common surgical need is for intestinal obstruction
Ganne et al[18]	PTLD was found to respond to rituximab irrespective of EBV status. Patients with higher EBV titers usually benefited from combination RIS, rituximab, and CHOP therapy. EBV-specific donor cytotoxic lymphocyte infusions may be effective but may lead to graft rejection. GI bleeding may be a presenting feature of disease

PTLD: Post-transplant lymphoproliferative disorder; EBV: Epstein-Barr virus; RIS: Immunosuppression; GI: Gastrointestinal.