Post-transplant Lymphoproliferative Disorder (PTLD) because of the Epstein-Barr Virus (EBV) is a major concern after pediatric transplantation. The group at greatest risk is EBV-seronegative recipients who receive EBV-seropositive organs. Additional risk factors remain to be determined, including those among EBV-seropositive recipients. In this case-control study, PTLD cases were biopsy-proven over a period of 4 yr (1997-2000, inclusive). Each case was matched with 2 controls, based on the type of organ transplanted and the period of transplantation (+/-1 yr). Variables compared between cases and controls included those relating to the clinical and virologic profiles and immunosuppressive therapy. Twenty-two cases of PTLD were diagnosed during the study period. PTLD cases occurred at a median of 22.8 months post-transplantation (range 1-131). The median age of cases was 26.2 months (range 6.1-194) compared with 47.4 months (range 0.8-202.2) for controls (p = 0.93). Cases had a higher mean baseline EBV load compared with controls (3.1 log(10) (s.d. +/- 1.0) vs. 1.6 log(10)/10(6) PBMCs (s.d. +/- 1.4), with every 1 log increase in viral load resulting in a three times increase in the likelihood of PTLD (p < 0.007). Close to one in four cases of PTLD were EBV-seropositive pretransplantation. These seropositive recipients tended to be older patients with a trend to a worse outcome compared with their seronegative counterparts. The occurrence of PTLD was not associated with the use of any specific immunosuppressants. A significant proportion of PTLD cases occurred among EBV-seropositive transplant recipients, with a tendency towards an unfavorable outcome. Besides EBV-seronegative recipients who receive seropositive organs, some EBV-seropositive pediatric patients are at risk of PTLD. Additional studies are warranted to further define the factors associated with PTLD in EBV-seropositive transplant recipients.

Raeside JI, Wilkinson CR, Farkas G. Ontogenesis of estrogen secretion by porcine fetal testes. Acta Endocrinol 1993;128:549-54. ISSN 0001-5598 High levels of estrogen secretion is a characteristic of steroidogenesis in the pig testis in both the adult and newborn male. We have now examined the ability of fetal gonads to secrete estrogens, and compared it with testosterone secretion during prenatal development. Fetuses were recovered from sows (N=33) at 27\p=n-\114(term) days of gestation. Gonads were removed for organ culture in TC-199 medium, or used as minced tissues or free cell preparations when taken later in development. Organ cultures were maintained for 96 h with luteinizing hormone added for the last 72 h for one gonad of each pair. Estrone, estradiol-1 7\g=b\ and testosterone were measured by radioimmunoassay in media samples. Trace amounts of estrone were detected almost as early as testosterone secretion commenced, but quantities sufficient for confirmation by radioimmunoassay after chromatography were not seen until day 35 of gestation. Estrogen production increased to >0.37 nmol\m=.\gonad-1\m=.\4 h-1 at term. Testosterone secretion in organ culture was increased by luteinizing hormone but no effect was seen on estrone levels for the first half of pregnancy. Thus, estrogen secretion is a feature of steroidogenesis in the porcine testes even in the early stages of fetal development. // Raeside,