Tonsillectomy in post-transplant lymphoproliferative disease in children

Objectives/Hypothesis: To review the role of tonsillectomy in diagnosis and management of post-transplant lymphoproliferative disorder (PTLD). Study Design: Case series using a retrospective chart review. Methods: A retrospective review of post-transplant lymphoproliferative disease at a tertiary academic medical center from January 2004 to April 2008. Data extracted includes patients' gender, age at transplantation, year of transplantation and tonsillectomy, type of transplant, presenting symptoms, type of immunosuppression, and outcome. Results: Six out of 25 (24%) patients who underwent tonsillectomy were found to have PTLD. The patient's characteristics, gender, age at transplantation, year of transplantation and tonsillectomy, type of transplant, presenting symptoms, type of immunosuppression, and outcomes are discussed. Conclusions: In our series, tonsillar hypertrophy, male gender, young age at transplantation, and liver transplantation were associated with higher rates of PTLD. Given the devastating nature of PTLD, early detection with tonsillectomy and institution of treatment is critical.