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https://www.readbyqxmd.com/read/29021960/relapsing-ebv-encephalitis-in-a-renal-transplant-recipient
#1
Joshua A Stone, Bettina M Knoll, Dimitrios Farmakiotis
In solid organ transplant recipients, Epstein-Barr virus (EBV) can cause active central nervous system (CNS) infection or malignant transformation of latently infected cells in the CNS, known as post-transplant lymphoproliferative disease (PTLD). Reduction of T-cell immunosuppression is the cornerstone of management. The role of antivirals with in-vitro activity against herpesviruses in EBV-related CNS syndromes is controversial, as they have no effect on latent virus. We report an unusual case of relapsing EBV encephalitis in a donor-positive, EBV-negative renal transplant recipient, with response to valganciclovir...
2017: IDCases
https://www.readbyqxmd.com/read/29021921/post-transplant-lymphoproliferative-disorder-ptld-single-institutional-experience-of-141-patients
#2
Rohit Bishnoi, Ravneet Bajwa, Aaron J Franke, William Paul Skelton, Yu Wang, Niraj M Patel, William Birdsall Slayton, Fei Zou, Nam H Dang
BACKGROUND: Post-transplant lymphoproliferative disorder is a well-recognized but rare complication of hematopoietic stem cell and solid organ transplant. Due to rarity of this disease, retrospective studies from major transplant centers has been the main source to provide treatment guidelines, which are still in evolution. The sample size of this study is among one of the largest study on PTLD till date reported throughout the world. METHODS: This study was performed at University of Florida which is one of the largest transplant center in South East United States...
2017: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/28984115/ebv-positive-post-transplant-lymphoproliferative-disorder-presenting-as-primary-diffuse-large-b-cell-lymphoma-of-the-central-nervous-system
#3
Haoliang Xu, Julia Rewerska, Nathan Aardsma, Konstantin Slavin, Tibor Valyi-Nagy, Hongyu Ni
Primary central nervous system post-transplant lymphoproliferative disorder (PCNS-PTLD) is a rare complication with inferior survival outcomes in solid organ transplant patients. It represents approximately 7-15% of all PTLD patients. Because of the rarity of this disease, the diagnosis of PCNS-PTLD is often challenging, and the optimal therapy has not been established. We report a case of a renal transplant patient who initially presented with acute altered neurological function, an enhancing mass lesion of the brain on magnetic resonance imaging (MRI), and nonspecific reactive histopathological changes on brain biopsy...
2017: Folia Neuropathologica
https://www.readbyqxmd.com/read/28964482/post-transplant-lymphoproliferative-disorder-after-solid-organ-transplant-in-children
#4
Michael J Absalon, Ruby A Khoury, Christine L Phillips
The post-transplant lymphoproliferative disorders (PTLD) are a diverse group of potentially life-threatening conditions affecting organ transplant recipients. PTLD arises in the setting of an attenuated host immunologic system that is manipulated to allow a foreign graft but then fails to provide adequate immune surveillance of transformed malignant or premalignant lymphocytes. The diversity of biological behavior and clinical presentation makes for a challenging clinical situation for those involved in the care of children with PTLD occurring after solid-organ transplantation...
August 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28915342/transplantation-of-solid-organ-recipients-shedding-epstein-barr-virus-dna-pretransplant-a-prospective-study
#5
Priya S Verghese, David O Schmeling, Emma A Filtz, Jennifer M Grimm, Arthur J Matas, Henry H Balfour
Epstein-Barr virus (EBV) poses a significant threat to patient and graft survival posttransplant. We hypothesized that recipients who shed EBV at transplant had less immunologic control of the virus and hence were more likely to have active EBV infection and disease posttransplant. To test this hypothesis, we conducted a 5-year prospective study in primary solid organ transplant recipients. We measured EBV DNA in oral washes and blood samples by quantitative PCR before transplant and periodically thereafter for up to 4 years...
September 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28906028/graft-outcomes-following-diagnosis-of-post-transplant-lymphoproliferative-disease-in-pediatric-kidney-recipients-a-retrospective-study
#6
Nele K Kanzelmeyer, Britta Maecker-Kolhoff, Henriette Zierhut, Christian Lerch, Murielle Verboom, Dieter Haffner, Lars Pape
Data related to graft outcomes following post-transplant lymphoproliferative disease (PTLD) in pediatric kidney transplantation are scarce. Data were analyzed retrospectively from 12 children (eight boys) for 3 years after diagnosis of PTLD, with a loss of follow-up after 2 years in two of 12. In all cases, intensity of immunosuppressive therapy was reduced, which switched from calcineurin inhibitor to a mammalian target of rapamycin (mTOR) inhibitor in six cases. Nine children were treated with six doses of rituximab according to the PED-PTLD-2005 protocol, with additional treatment in one child as per protocol...
September 14, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28874674/lytic-ebv-infection-investigated-by-detection-of-soluble-epstein-barr-virus-zebra-in-the-serum-of-patients-with-ptld
#7
Mohammed Habib, Marlyse Buisson, Julien Lupo, Felix Agbalika, Gérard Socié, Raphaele Germi, Monique Baccard, Berthe-Marie Imbert-Marcille, Jacques Dantal, Patrice Morand, Emmanuel Drouet
The ZEBRA protein (encoded by the BZLF1 gene), is the major transcription factor of EBV, expressed upon EBV lytic cycle activation. Several studies highlighted the critical role of EBV lytic infection as a risk factor for lymphoproliferative disorders like post-transplant lymphoproliferative disease (PTLD). Here, we use an antigen-capture ELISA assay specifically designed to detecting the circulating soluble ZEBRA (sZEBRA) in serum samples (threshold value determined at 40ng/mL). We retrospectively investigated a population of 66 transplanted patients comprising 35 PTLD...
September 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28869325/epstein-barr-virus-infection-in-children-with-renal-transplantation-a-single-center-experience
#8
Jihye You, Mijin Kim, Jina Lee, Duck Jong Han, Young Seo Park, Joo Hoon Lee
AIM: This study aimed to investigate the incidence, timing, manifestations, managements, and outcomes of Epstein-Barr virus (EBV) infection in pediatric renal transplant recipients in Korea. METHODS: We retrospectively evaluated 70 patients aged <18 years who had undergone renal transplantation between January 1990 and November 2014 at a single center in Korea. EBV infection was diagnosed via serological test or real-time quantitative polymerase chain reaction (PCR)...
September 4, 2017: Nephrology
https://www.readbyqxmd.com/read/28846558/improved-outcomes-of-kidney-transplantation-in-infants-age-2-years-a-single-center-experience
#9
Blanche M Chavers, Michelle N Rheault, Arthur J Matas, Scott C Jackson, Marie E Cook, Thomas E Nevins, John S Najarian, Srinath Chinnakotla
BACKGROUND: Infants (age < 2 years) with end stage renal disease (ESRD) have increased morbidity and mortality. We evaluated our long-term outcomes of kidney transplants (KTx) in infants. METHODS: Between 1984-2014, 136 infants underwent KTx. We examined trends in survival rates and complications by era (1984-1993 [Era 1], 1994-2003 [Era 2], 2004-2014 [Era 3]). RESULTS: Patients were 92.6% Caucasian and 70.6% male. PostTx initial length of hospital stay declined 37% over the 30-year period (p <0...
August 24, 2017: Transplantation
https://www.readbyqxmd.com/read/28838455/an-unusual-posttransplant-t-cell-lymphoma-after-liver-transplantation-a-case-report
#10
I E Obiorah, M Ozdemirli
Posttransplantation lymphoproliferative disorders (PTLDs) encompass a spectrum of heterogeneous entities ranging from benign lymphocytic proliferations to high-grade malignant lymphomas. The majority of PTLDs are associated with reactivation of Epstein-Barr virus (EBV), which induces B-cell proliferation and occurs in the setting of severe immune suppression after solid organ or bone marrow transplantation. T-cell/natural killer cell PTLDs are relatively rare, constituting ∼15% of all cases. T-cell PTLDs are usually aggressive, and outcomes are poor...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28833879/into-thin-air-predicting-ptld-in-pediatric-lung-transplant-patients
#11
EDITORIAL
Daniel E Dulek, Marian G Michaels
No abstract text is available yet for this article.
September 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28831836/long-term-outcome-of-epstein-barr-virus-dnaemia-and-ptld-with-the-use-of-preemptive-rituximab-following-allogeneic-hsct
#12
Amelie Kinch, Helene Hallböök, Johan Arvidson, Kalle Sällström, Kåre Bondeson, Karlis Pauksens
We studied retrospectively the outcome of Epstein-Barr virus (EBV)-related disease with EBV monitoring and preemptive rituximab to prevent post-transplant lymphoproliferative disorder (PTLD) in 319 consecutive allogeneic stem cell transplantations 2004-2012. Patients who received anti-thymocyte globulin (ATG) or alemtuzumab were regarded as high-risk for PTLD (n = 214). EBV DNAemia ≥1000 copies/mL plasma was observed in 50 (23%) of the high-risk patients. Thirty-three of the high-risk (15%) and one of the low-risk (1%) patients received rituximab, in combination with reduction of immunosuppression (n = 24) or chemotherapy (n = 4)...
August 23, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28818847/a-french-cohort-study-of-kidney-retransplantation-after-post-transplant-lymphoproliferative-disorders
#13
Sophie Caillard, Etienne Cellot, Jacques Dantal, Olivier Thaunat, François Provot, Bénédicte Janbon, Matthias Buchler, Dany Anglicheau, Pierre Merville, Philippe Lang, Luc Frimat, Charlotte Colosio, Eric Alamartine, Nassim Kamar, Anne Elisabeth Heng, Antoine Durrbach, Valérie Moal, Joseph Rivalan, Isabelle Etienne, Marie Noelle Peraldi, Anne Moreau, Bruno Moulin
BACKGROUND AND OBJECTIVES: Post-transplant lymphoproliferative disorders arising after kidney transplantation portend an increased risk of morbidity and mortality. Retransplantation of patients who had developed post-transplant lymphoproliferative disorder remains questionable owing to the potential risks of recurrence when immunosuppression is reintroduced. Here, we investigated the feasibility of kidney retransplantation after the development of post-transplant lymphoproliferative disorder...
October 6, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28766544/-ebv-positive-central-nervous-system-lymphoproliferative-disease-associated-with-immunosuppression-after-organ-transplantation-long-term-remission-without-chemotherapy
#14
O A Gavrilina, V V Troitskaya, E E Zvonkov, E N Parovichnikova, G M Galstyan, L S Biryukova, I V Nesterenko, A M Kovrigina, A V Bazhenov, V G Savchenko, V G Savchenko
Primary central nervous system (CNS) lymphomas account for 13-20% of the posttransplant lymphoproliferative disorders (PTLD) and rank among the most aggressive conditions. Reduction of immunosuppressive therapy should be mandatory to treat PTLD, but this is rarely used as the only therapy option. Chemotherapy regimens for PTLD involving the CNS most commonly include high-dose rituximab and high-dose methotrexate and/or cytarabine. The efficiency only of discontinuation of immunosuppressive therapy for PTLD does not exceed 5-10%, but there are no literature data on its efficiency for PTLD involving the CNS...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28756359/post-transplant-lymphoproliferative-disorder-and-management-of-residual-mass-post-chemotherapy-case-report
#15
Troy D Schultz, Nubia Zepeda, Ronald B Moore
INTRODUCTION: Post-transplant lymphoproliferative disorder (PTLD) is a rare complication. It represents a spectrum of lymphoid proliferations which occur in the setting of immunosuppression and organ transplantation. There are no reported cases or recommendations for the treatment of residual masses post rituximab of PTLD. PRESENTATION OF CASE: A patient with a long standing history of immunosuppression due to multiple kidney transplants starting in 1979, presented with a very large palpable hard abdominal mass (2004) after a fourth renal transplant...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28748904/native-kidney-posttransplant-lymphoproliferative-disorder-in-a-renal-transplant-recipient
#16
Abhilash Chandra, Anupama Kaul, Vinita Aggarwal, Divya Srivastava
Compared with the general population, cancer risk in kidney transplant recipients is much higher. In the present study, we report a patient who was diagnosed with posttransplant lymphoproliferative disorder (PTLD) and had a fulminant course, dying within few days of diagnosis. This case report highlights the importance of timely detection and treatment of PTLD as it is associated with high mortality rate.
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28717085/high-dose-chemotherapy-with-stem-cell-rescue-provided-durable-remission-for-classical-hodgkin-lymphoma-type-post-transplant-lymphoproliferative-disorder-after-unrelated-cord-blood-transplantation-a-case-report-and-review-of-the-literature
#17
Hidehiro Itonaga, Takeharu Kato, Machiko Fujioka, Masataka Taguchi, Hiroaki Taniguchi, Yoshitaka Imaizumi, Shinichiro Yoshida, Hiroaki Miyoshi, Yukiyoshi Moriuchi, Koichi Ohshima, Yasushi Miyazaki
An adult woman developed polymorphic post-transplant lymphoproliferative disorder (PTLD) 58 months after unrelated cord blood transplantation. She was treated successfully with chemotherapy and radiation therapy but presented with lymphadenopathy and splenomegaly 74 months after transplantation. A lymph node biopsy confirmed the diagnosis of nodular sclerosis type Hodgkin lymphoma (classical Hodgkin lymphoma [CHL]-type PTLD). After salvage therapy and hematopoietic stem cell harvesting, she was subsequently treated with consolidative high-dose chemotherapy with melphalan followed by stem cell rescue, which resulted in durable remission...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28714558/everolimus-and-reduced-calcineurin-inhibitor-therapy-in-pediatric-liver-transplant-recipients-results-from-a-multicenter-prospective-study
#18
Rainer Ganschow, Bo-Goran Ericzon, Anil Dhawan, Khalid Sharif, El-Djouher Martzloff, Barbara Rauer, Jennifer Ng, Patricia Lopez
In a 24-month, multicenter, single-arm, prospective study, 56 pediatric liver transplant patients with or without basiliximab induction were converted at 1-6 months post-transplant from standard calcineurin inhibitor (CN) therapy (± mycophenolic acid), to everolimus with reduced exposure to CNI (tacrolimus n=50, cyclosporine n=6). Steroid therapy was optional. Recruitment was stopped prematurely due to high rates of PTLD, treatment-related serious infections leading to hospitalization and premature study drug discontinuation...
November 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28708333/conversion-from-calcineurin-inhibitors-to-mtor-inhibitors-as-primary-immunosuppressive-drugs-in-pediatric-heart-transplantation
#19
Alfred Asante-Korang, Jennifer Carapellucci, Diane Krasnopero, Abigail Doyle, Brian Brown, Ernest Amankwah
There are only a few reports of successful use of mammalian target of rapamycin (mTORI) as primary immunosuppression in pediatric heart transplantation. Compared to calcineurin inhibitors, mTORI have less side effects, especially nephrotoxicity, infections, and malignancies. A retrospective study was conducted at our institution of all 170 heart transplants from 1995 to 2015. Nineteen patients were switched from tacrolimus (n=15) or cyclosporin (n=4) to everolimus (n=4) or sirolimus (n=15) due to nephrotoxicity (n=5), malignancy (n=8), EBV viremia/reactive plasmacytic changes (n=5), and immune hemolytic anemia (n=1)...
July 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28706985/clinical-utility-of-epstein-barr-virus-viral-load-monitoring-and-risk-factors-for-posttransplant-lymphoproliferative-disorders-after-kidney-transplantation-a-single-center-10-year-observational-cohort-study
#20
Erica Franceschini, Jessica Plessi, Stefano Zona, Antonella Santoro, Margherita Digaetano, Francesco Fontana, Gaetano Alfano, Giovanni Guaraldi, Patrizia Comoli, Francesca Facchini, Leonardo Potenza, William Gennari, Mauro Codeluppi, Mario Luppi, Gianni Cappelli, Inge C Gyssens, Cristina Mussini
BACKGROUND: Posttransplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality in solid organ transplants. Epstein Barr virus (EBV) plays a major role in PTLD development. Guidelines recommend EBV viral load (VL) monitoring in high-risk populations in the first year. METHODS: Retrospective observational study in all adult patients who had at least 1 EBV-VL performed in the postkidney transplant (KT) period from January 2005 to December 2014 at the Policlinico Modena Hospital...
July 2017: Transplantation Direct
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