Posttransplant viral syndromes in pediatric patients: a review

Pearlman, Lisa S.

doi:10.7182/prtr.12.2.y334106037764778

“…34,51 A recent review found that the incidence of PTLD in the pediatric transplant population has been reported to be as high as 10% in heart transplant recipients, 22% in lung transplant recipients, 20% in liver recipients, and up to 40% in patients with multivisceral grafts. 52 Another study reported a PTLD frequency of 10.1% in a pediatric kidney transplant population compared with a PTLD frequency of 1.2% in an adult kidney transplant population. 53 Of pediatric PTLD cases reported to the IPITTR, 61% received nonkidney transplants.…”

Section: Pediatric Patients At Greater Risk Than Adultsmentioning

confidence: 98%

Posttransplant Malignancy

Trofe

¹

,

Beebe

²

,

Buell

³

et al. 2004

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In the past few decades, great advances have been made in the field of solid-organ transplantation. A greater understanding of immune system function, the development of modern immunosuppression, and advancements in surgical technique have led to marked improvements in both recipient and graft survivals, as well as recipients' quality of life. However, improved survival rates have also led to prolonged exposure to chronic immunosuppression, which increases the risk for the development of posttransplant malignancies. In addition, older transplant candidates are being considered, carrying with them the increased likelihood of preexisting malignancy. Consequently, the potential risk of posttransplant malignancy must be considered. Moreover, as long-term transplant survivors continue to age, posttransplant malignancies will be seen more frequently. This review presents the more commonly encountered posttransplant malignancies and the measures that are currently being utilized to prevent and treat them.

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Anaplastic Large Cell Lymphoma Associated With Epstein-Barr Virus Following Cardiac Transplant

Pitman¹,

Rowsell²,

Cao³

et al. 2004

The American Journal of Surgical Pathology

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Posttransplantation lymphoproliferative disorders (PTLDs) eventually occur in approximately 5% of all organ transplant recipients. Most of cases are B-cell proliferations associated with the Epstein-Barr virus (EBV). T-cell PTLDs are relatively rare, although some estimate that up to 14% of posttransplantation malignant lymphomas are T-cell lymphomas even though only a few of these cases are described in the literature. A literature review found only 77 cases of T-cell PTLD, including 1 case following cardiac transplant, 15 cases associated with EBV, and only 1 case of anaplastic large cell lymphoma (ALCL). This single ALCL case followed a liver transplant, was of the T-cell phenotype, and was EBV negative. In this report, we describe a 14-year-old male who developed an EBV-positive, T-cell PTLD of the ALCL subtype after a period of 14 years following cardiac transplant. Immunohistochemical staining established the T-cell origin of the neoplasm with strong expression of CD45, CD3, CD43, and CD2 and also showed expression of CD30 consistent with the histologic features that suggested ALCL. EBER in situ hybridization detected the presence of the EBV. Polymerase chain reaction analysis for T-cell receptor-gamma gene rearrangements confirmed the T-cell lineage of this lymphoma. To our knowledge, this is the first reported case of an EBV-positive T cell lymphoma of the anaplastic large cell subtype following organ transplant.

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Posttransplant malignancy

Trofe¹,

Beebe²,

Buell³

et al. 2004

Progress in Transplantation

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In the past few decades, great advances have been made in the field of solid-organ transplantation. A greater understanding of immune system function, the development of modern immunosuppression, and advancements in surgical technique have led to marked improvements in both recipient and graft survivals, as well as recipients' quality of life. However, improved survival rates have also led to prolonged exposure to chronic immunosuppression, which increases the risk for the development of posttransplant malignancies. In addition, older transplant candidates are being considered, carrying with them the increased likelihood of preexisting malignancy. Consequently, the potential risk of posttransplant malignancy must be considered. Moreover, as long-term transplant survivors continue to age, posttransplant malignancies will be seen more frequently. This review presents the more commonly encountered posttransplant malignancies and the measures that are currently being utilized to prevent and treat them.

show abstract

Posttransplant viral syndromes in pediatric patients: a review

Cited by 3 publications

References 31 publications

Posttransplant Malignancy

Posttransplant Malignancy

Anaplastic Large Cell Lymphoma Associated With Epstein-Barr Virus Following Cardiac Transplant

Posttransplant malignancy

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