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https://www.readbyqxmd.com/read/28639398/epstein-barr-viral-loads-do-not-predict-post-transplant-lymphoproliferative-disorder-in-pediatric-lung-transplant-recipients-a-multicenter-prospective-cohort-study
#1
Andrew Parrish, Matthew Fenchel, Gregory A Storch, Richard Buller, Sheila Mason, Nikki Williams, David Ikle, Carol Conrad, Albert Faro, Samuel Goldfarb, Don Hayes, Ernestina Melicoff-Portillo, Marc Schecter, Gary Visner, Stuart Sweet, Lara Danziger-Isakov
Prediction of PTLD after pediatric lung transplant remains difficult. Use of EBV VL in WB has been poorly predictive, while measurement of VL in BAL fluid has been suggested to have enhanced utility. The NIH-sponsored Clinical Trials in Organ Transplantation in Children (CTOTC-03) prospectively obtained serial quantitative measurements of EBV PCR in both WB and BAL fluid after pediatric lung transplantation. Descriptive statistics, contingency analyses, and Kaplan-Meier analyses evaluated possible association between EBV and PTLD...
June 21, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28636627/plasma-cell-neoplasia-after-kidney-transplantation-french-cohort-series-and-review-of-the-literature
#2
Raphaël Kormann, Hélène François, Thibault Moles, Jacques Dantal, Nassim Kamar, Karine Moreau, Thomas Bachelet, Anne-Elisabeth Heng, Antoine Garstka, Charlotte Colosio, Didier Ducloux, Johnny Sayegh, Benjamin Savenkoff, Denis Viglietti, Rebecca Sberro, Eric Rondeau, Julie Peltier
Although post-transplant lymphoproliferative disorder (PTLD) is the second most common type of cancer in kidney transplantation (KT), plasma cell neoplasia (PCN) occurs only rarely after KT, and little is known about its characteristics and evolution. We included twenty-two cases of post-transplant PCN occurring between 1991 and 2013. These included 12 symptomatic multiple myeloma, eight indolent myeloma and two plasmacytomas. The median age at diagnosis was 56.5 years and the median onset after transplantation was 66...
2017: PloS One
https://www.readbyqxmd.com/read/28614191/anti-cd20-blocker-rituximab-in-kidney-transplantation
#3
Puneet Sood, Sundaram Hariharan
Rituximab is a chimeric anti-CD20 monoclonal protein used in various clinical scenarios in kidney transplant recipients. However, its evidence-based use there remains limited due to lack of controlled studies, limited sample size, short follow-up and poorly defined endpoints. Rituximab is indicated for CD20+ PTLD. It may be beneficial for treating recurrent MN and recurrent allograft ANCA vasculitis and possibly for recurrent FSGS. Rituximab, in combination with IVIG/PP, appears to decrease antibody level and increase the odds of transplantation in sensitized recipients...
June 13, 2017: Transplantation
https://www.readbyqxmd.com/read/28612477/preliminary-experience-on-the-use-of-pet-ct-in-the-management-of-pediatric-post-transplant-lymphoproliferative-disorder
#4
Pilar Guerra-García, Steffen Hirsch, Daniel S Levine, Mary M Taj
INTRODUCTION: Post-transplant lymphoproliferative disorder (PTLD) is a well-known complication following prolonged immunosuppression. Contrary to other lymphomas, there is no standardized imaging approach to assess PTLD either at staging or for response to therapy. Positron emission tomography/computed tomography (PET/CT) is an imaging modality that has proven to be useful in lymphoma. However, there is still limited data concerning its use in pediatric PTLD. Our study evaluates the use of PET/CT in pediatric PTLD at our institution...
June 14, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28604230/primary-cutaneous-post-liver-transplant-lymphoproliferative-disorder-ptld-successfully-treated-with-radiotherapy
#5
Aizuri Murad, Kieran Sheahan, Brian Kirby
A post liver transplant patient developed lesions with the clinical features suggestive of SCC-in-situ on his face and chest which occurred simultaneously since six months prior to his presentation. Skin histopathology confirmed the diagnosis of SCC-in-situ with additional plasmalymphocytic infiltrate in the dermis. Immunohistochemistry with his clinical presentation were in keeping with primary cutaneous post-transplant lymphoproliferative disorder (PTLD). He did not have any systemic involvement. Lesions were treated with radiotherapy with good response...
June 12, 2017: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/28581032/preemptive-therapy-with-rituximab-for-epstein-barr-virus-reactivation-after-haplo-hsct
#6
Shogo Kobayashi, Hideki Sano, Kazuhiro Mochizuki, Yoshihiro Ohara, Nobuhisa Takahashi, Hitoshi Ohto, Atsushi Kikuta
BACKGROUND: Epstein-Barr virus-related post-transplantation lymphoproliferative disorder (EBV-PTLD) is a serious complication in hematopoietic stem cell transplantation (HSCT) recipients. METHODS: We conducted a retrospective study to investigate the incidence and potential risk factors for EBV reactivation and to assess the efficacy of the management of EBV reactivation with preemptive rituximab in children who had T-cell-replete haploidentical HSCT (TCR-haplo-SCT) with low-dose anti-thymocyte globulin (ATG)...
June 5, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28574195/pharmacoepidemiology-of-tacrolimus-in-pediatric-liver-transplantation
#7
Natalia Riva, Paula Schaiquevich, Paulo Cáceres Guido, Esteban Halac, Marcelo Dip, Oscar Imventarza
AEs during immunosuppressive treatment with tacrolimus are very common. We retrospectively evaluated FK safety and efficacy in a large pediatric liver transplant cohort in Latin America. During 2-year follow-up, we analyzed data from patients who underwent liver transplantation over the period 2010-2012 and recorded FK exposure, AEs, and AR episodes. AEs were classified according causality and severity. Tacrolimus exposure before and during AE was compared using Wilcoxon matched-pairs test. Kaplan-Meier curves were used for survival analysis...
June 2, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28556519/lessons-learned-early-termination-of-a-randomized-trial-of-calcineurin-inhibitor-and-corticosteroid-avoidance-using-belatacept
#8
Kenneth A Newell, Aneesh K Mehta, Christian P Larsen, Peter G Stock, A Bradley Farris, Shikha G Mehta, David Ikle, Brian Armstrong, Yvonne Morrison, Nancy Bridges, Mark Robien, Roslyn B Mannon
The intent of this NIH-sponsored study was to compare a belatacept-based immunosuppressive regimen with a maintenance regimen of tacrolimus and mycophenolate (MMF). Nineteen primary, EBV-immune renal transplant recipients with a negative cross-match were randomized to one of three groups. All patient groups received perioperative steroids and maintenance MMF. Patients in groups 1 and 2 were induced with alemtuzumab and maintained on tacrolimus or belatacept, respectively. Patients in group 3 were induced with basiliximab, received 3 months of tacrolimus, and maintained on belatacept...
May 28, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28553044/postrenal-transplant-metastatic-colonic-neoplasm-posttransplant-lymphoproliferative-disorder-or-adenocarcinoma
#9
H Lal, P Yadav, M Dey, N Kumar
Transplant recipients are vulnerable to a horde of infections and neoplastic conditions due to immunosuppression. Posttransplant lymphoproliferative disorder (PTLD) is a condition unique to the transplant recipient occurring due to monoclonal lymphocytic proliferation. It may affect any organ system with reportedly highest incidence in the gastrointestinal tract. The incidence of adenocarcinoma of the colon, however, has not been shown to be uniformly higher in transplant recipients. We report here an unusual case of adenocarcinoma of the ascending colon presenting with liver, lymph node and skin metastasis in a transplant recipient, which simulated PTLD both clinically and radiologically...
May 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28540896/postrenal-transplant-malignancy-incidence-risk-factors-and-prognosis
#10
Nabil Abdelfadil Elserwy, Esam Elden Lotfy, Mohamad Ashraf Fouda, Medhat Ibrahim Mahmoud, Ahmed Farouk Donia, Mohamed Elsayed Mashaly, Mohamed Hamed Abbas, Mohamed Megahed Abuelmagd, Rasha Kamal Abouelenein, Mabrouk Ibrahim Ismail, Mohamed Adel Bakr
The newer and potent immunosuppressive agents have successfully reduced the risk of rejection after kidney transplantation, but the development of cardiovascular diseases, infections, and malignancy is major factors limiting their success. Posttransplantation malignancy is the second most common cause of death in renal transplant recipients after cardiovascular disease; it is expected that mortality due to malignancy may become the most common cause of death within the next two decades. This study is designed to evaluate the incidence, risk factors, and types of malignancies occurring after renal transplantation and their impact on patient and graft survival...
May 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28535360/posttransplant-lymphoproliferative-disorder-otolaryngological-manifestations-and-management
#11
Richard Heyes, Donald W Northfelt, David G Lott
Objective Posttransplant lymphoproliferative disorder (PTLD) is a unifying term for a spectrum of lymphoid expansion entities brought about by immunosuppression and is strongly associated with Epstein-Barr virus (EBV). Otolaryngological findings tend to present early in the clinical course; therefore, disease awareness among otolaryngologists is of utmost importance. This review synthesizes the body of literature pertaining to PTLD involving the head and neck, summarizes contemporary management, and highlights areas for future research...
May 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28513810/epstein-barr-virus-encephalitis-in-solid-organ-transplantation
#12
Jillian S Y S Y, Zhi Mei Low, Iain Abbott, Lani Shochet, John Kanellis, Richard A Kitching, Tony M Korman
Epstein-Barr virus (EBV) is typically associated with post transplant lymphoproliferative disease (PTLD) after solid organ and stem cell transplantation. However, it is rarely associated with neurological complications. We report a case of severe encephalitis complicating primary EBV infection six months post renal transplantation, and review the literature on EBV encephalitis in solid organ transplantation in adults. A 55-year-old male presented 6 months post cadaveric renal transplant with headache, fever and confusion...
May 17, 2017: New Microbiologica
https://www.readbyqxmd.com/read/28509395/da-epoch-r-for-post-transplant-lymphoproliferative-disorders-ptld
#13
Christin B DeStefano, Vera Malkovska, Hind Rafei, Aarthi Shenoy, Kelly Fitzpatrick, Anita Aggarwal, Joseph P Catlett
Post-transplant lymphoproliferative disorders (PTLD) are a heterogeneous and potentially fatal group of neoplasms arising in an immunodeficient environment in the background of viral antigenic stimulation. PTLD is rare, with an incidence in solid organ transplant recipients typically less than 20% [1]. For aggressive, monomorphic cases, current guidelines recommend reduced immunosuppression in addition to chemoimmunotherapy, which generally consists of R-CHOP [1]. Nevertheless, prognosis is poor with 5-year overall survival (OS) rates of only 40-60% [1]...
May 16, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28508661/post-transplant-lymphoproliferative-disease-in-liver-transplant-recipients
#14
Mercedes Rubio-Manzanares Dorado, José María Álamo Martínez, Carmen Bernal Bellido, Luis Miguel Marín Gómez, Gonzalo Suárez Artacho, Carmen Cepeda Franco, Jize Wang, Miguel Ángel Gómez Bravo, Francisco Javier Padillo
INTRODUCTION: Post-transplant lymphoproliferative syndrome (PTLD) is a rare and potentially life-threatening complication after liver transplantation. The aim of this study was to analyze the clinicopathologic features related to PTLD in a single institution after liver transplantation. METHODS: Observational study where we have retrospectively analyzed 851 cases who underwent liver transplantation. Ten cases have developed PTLD. Their clinical-pathological characteristics and the treatment received have been analyzed...
May 16, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28499936/umbilical-cord-blood-transplantation-without-antithymocyte-globulin-results-in-similar-survival-but-better-quality-of-life-compared-with-unrelated-peripheral-blood-stem-cell-transplantation-for-the-treatment-of-acute-leukemia-a-retrospective-study-in-china
#15
Juan Tong, Li Xuan, Yanling Sun, Dongping Huang, Huilan Liu, Changcheng Zheng, Xiaoyu Zhu, Baolin Tang, Kaidi Song, Xuhan Zhang, Lei Zhang, Wen Yao, Dongjun Lin, Qifa Liu, Zimin Sun
Although previous studies have demonstrated improved outcomes in umbilical cord blood transplantation (UCBT) by omitting antithymocyte globulin (ATG) in the conditioning regimen, this approach has not been comparatively studied in unrelated peripheral blood stem cell transplantation (UPBSCT). To compare the risks and benefits between UCBT without ATG and UPBSCT in patients with acute leukemia (AL), we conducted a multicenter retrospective study of 79 patients who underwent UCBT (myeloablative conditioning without ATG) and 96 patients who underwent UPBSCT (myeloablative conditioning with ATG)...
May 9, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28493355/consideration-of-difficulties-and-exit-strategies-in-a-case-of-face-allotransplantation-resulting-in-failure
#16
Özlenen Özkan, Ömer Özkan, Umuttan Doğan, Vural Taner Yılmaz, Hilmi Uysal, Levent Ündar, Ebru Apaydın Doğan, Ozan Salim, Anı Çinpolat, Atilla Ramazanoglu
We describe the first rescue procedure in a case of total face allotransplantation. The recipient was a 54-year-old man with severe disfigurement of the entire face following an accidental gunshot injury 5 years previously. The large defect included the maxilla, mandible, and mid-face. Full face procurement was performed from a multiorgan cadaveric donor and was allotransplanted to the recipient. The post-transplant induction immunosuppressive regimen included ATG combined with tacrolimus, mycophenolate mofetil, and prednisone, while maintenance was provided by the last three of these...
May 11, 2017: Microsurgery
https://www.readbyqxmd.com/read/28489256/clinical-and-virologic-outcomes-in-high-risk-adult-ebv-mismatched-organ-transplant-recipients
#17
Deepali Kumar, Nikhil Patil, Shahid Husain, Cecilia Chaparro, Mamatha Bhat, S Joseph Kim, Atul Humar
EBV D+/R- organ transplant recipients are a high-risk group for developing PTLD. Little data are available for prevention in the adult EBV mismatched population. We conducted a retrospective study of EBV D+/R- organ transplants performed during 2002-2014. Of the 153 patients identified, 82.4% patients received antiviral prophylaxis with valganciclovir for a median of 4.5 months (range 0.8-22 months) and 36.6% underwent viral load monitoring in the first post-transplant year. EBV viremia developed in 67.2% monitored patients...
May 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28487787/ebv-negative-monomorphic-b-cell-posttransplant-lymphoproliferative-disorder-with-marked-morphologic-pleomorphism-and-pathogenic-mutations-in-asxl1-bcor-cdkn2a-nf1-and-tp53
#18
Agata M Bogusz
Posttransplant lymphoproliferative disorders (PTLDs) are a diverse group of lymphoid or plasmacytic proliferations frequently driven by Epstein-Barr virus (EBV). EBV-negative PTLDs appear to represent a distinct entity. This report describes an unusual case of a 33-year-old woman that developed a monomorphic EBV-negative PTLD consistent with diffuse large B-cell lymphoma (DLBCL) 13 years after heart-lung transplant. Histological examination revealed marked pleomorphism of the malignant cells including nodular areas reminiscent of classical Hodgkin lymphoma (cHL) with abundant large, bizarre Hodgkin-like cells...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28465118/development-and-validation-of-a-major-adverse-transplant-event-mate-score-to-predict-late-graft-loss-in-pediatric-heart-transplantation
#19
Christopher S Almond, Helena Hoen, Joseph W Rossano, Chesney Castleberry, Scott R Auerbach, Lingyao Yang, Ashwin K Lal, Melanie D Everitt, Matthew Fenton, Seth A Hollander, Elfriede Pahl, Elizabeth Pruitt, David N Rosenthal, Doff B McElhinney, Kevin P Daly, Manisha Desai
BACKGROUND: There is inadequate power to perform a valid clinical trial in pediatric heart transplantation (HT) using a conventional end-point, because the disease is rare and hard end-points, such as death or graft loss, are infrequent. We sought to develop and validate a surrogate end-point involving the cumulative burden of post-transplant complications to predict death/graft loss to power a randomized clinical trial of maintenance immunosuppression in pediatric HT. METHODS: Pediatric Heart Transplant Study (PHTS) data were used to identify all children who underwent an isolated orthotopic HT between 2005 and 2014 who survived to 6 months post-HT...
March 24, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28456611/increased-risk-of-ptld-in-lung-transplant-recipients-with-cystic-fibrosis
#20
Erin M Lowery, William Adams, Shellee A Grim, Nina M Clark, Leah Edwards, Jennifer E Layden
BACKGROUND: Post-transplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality following lung transplantation. Recipients with cystic fibrosis (CF) may have an increased risk of PTLD although the literature is limited to single center cohorts. Our primary aim is to examine PTLD in an adult lung transplant population by utilizing the International Society for Heart and Lung Transplantation Registry. METHODS: We studied 30,598 adult recipients of lung transplants performed between 1999 and 2011...
April 26, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
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