Microsatellite analysis in post-transplantation lymphoproliferative disorder to determine donor/recipient origin

Post-transplantation lymphoproliferative disorders (PTLD) are a group of he terogeneous diseases that occur after organ transplantation. Determination of the origin of the tumor cells not only provides clues to its possible pa thogenetic mechanism, but also gives prognostic guidance in the clinical ma nagement of patients. We reviewed the clinicopathological features of four cases of PTLD that developed after solid organ transplantation. Using micro satellite analysis performed on paraffin-embedded tissue and using multiple , highly polymorphic markers, we have successfully determined the recipient / donor origin of the tumor cells in all of them. The time of onset of the PTLD ranged from 5 to 11 mo. All cases were diffuse large cell lymphomas of B-cell lineage, and the two cases that have been tested for EBV by in situ hybridization were positive. Three of the 4 PTLD were of donor origin and these three patients died of diseases unrelated to PTLD. The single patient with PTLD of recipient origin died of disseminated PTLD. The mean survival length of the three patients with donor origin was 26.3 mo, whereas that o f the patient with recipient origin was 12 mo. Our results indicate a relat ively high incidence of PTLD of donor origin among our patients with solid organ transplantation, as compared to other reported series. Moreover, the finding of the relatively indolent nature of PTLD of donor origin supports that determination of the donor/recipient origin of PTLD is of prognostic s ignificance.