2025 ICD-10-CM code D47.Z1
(Active) Effective Date: N/A Neoplasms - Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes Neoplasms (C00-D49) Feed
Post-transplant lymphoproliferative disorder (PTLD).
The medical necessity for PTLD treatment is established by the diagnosis itself, as it's a life-threatening condition. Treatment is crucial to controlling the disease and preventing further complications.
The diagnosis of PTLD is made based on medical history, physical examination, and laboratory tests including PCR studies for EBV. Imaging studies such as CT, MRI, and PET scans are also used for diagnosis and staging. Treatment typically involves reducing or stopping immunosuppressant medication, alongside antiviral therapy, monoclonal antibody therapy, and chemotherapy or radiotherapy.
In simple words: PTLD is a serious complication that can occur after an organ or tissue transplant. It's a type of cancer linked to the Epstein-Barr virus (EBV), often found in the donated organ. This condition usually appears within the first year after the transplant and can affect various parts of the body like lymph nodes, liver, lungs, and even the brain.
Post-transplant lymphoproliferative disorder (PTLD) refers to a malignant complication of solid organ transplantation (SOT) and allogeneic hematopoietic stem cell transplantation (HSCT), primarily associated with reactivation of Epstein–Barr virus (EBV) infection of B cells, typically in the donor tissue, but it can be due to reactivation of recipient infection.
Example 1: A patient who received a kidney transplant six months prior presents with enlarged lymph nodes, fever, and fatigue. After further investigation including EBV PCR and biopsy, a diagnosis of PTLD is confirmed., A liver transplant recipient develops gastrointestinal issues and respiratory difficulties one year post-transplant. Imaging reveals lesions in the lungs and small intestine. Biopsy and EBV testing confirm PTLD., A patient undergoing immunosuppressive therapy following a heart transplant presents with central nervous system symptoms. Lumbar puncture and EBV tests confirm CNS involvement of PTLD.
Documentation should include evidence of transplantation, the presence of EBV infection, biopsy results confirming lymphoproliferative disorder, and imaging reports showing the extent of the disease.
- Specialties:Oncology, Hematology, Transplant Surgery, Infectious Disease
- Place of Service:Inpatient Hospital, Outpatient Hospital, Physician's Office