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https://www.readbyqxmd.com/read/28915342/transplantation-of-solid-organ-recipients-shedding-epstein-barr-virus-dna-pretransplant-a-prospective-study
#1
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/28874674/lytic-ebv-infection-investigated-by-detection-of-soluble-epstein-barr-virus-zebra-in-the-serum-of-patients-with-ptld
#2
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
#3
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
#4
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
#5
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/28831836/long-term-outcome-of-epstein-barr-virus-dnaemia-and-ptld-with-the-use-of-preemptive-rituximab-following-allogeneic-hsct
#6
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/28766544/-ebv-positive-central-nervous-system-lymphoproliferative-disease-associated-with-immunosuppression-after-organ-transplantation-long-term-remission-without-chemotherapy
#7
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/28708333/conversion-from-calcineurin-inhibitors-to-mtor-inhibitors-as-primary-immunosuppressive-drugs-in-pediatric-heart-transplantation
#8
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
#9
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
https://www.readbyqxmd.com/read/28699897/posttransplant-lymphoproliferative-disorders-in-kidney-transplant-recipients-a-retrospective-cohort-analysis-over-two-decades-in-hong-kong
#10
Chi Yuen Cheung, Maggie Kam Man Ma, Ka Foon Chau, Wai Leung Chak, Sydney Chi Wai Tang
OBJECTIVE: To characterize the posttransplant lymphoproliferative disorders (PTLD) including the Epstein-Barr virus (EBV) status, histological subgroups, site of occurrence and the clinical outcome in the Chinese kidney transplant recipients. METHODS: A retrospective cohort study of 1, 227 adult kidney transplant recipients who were followed up in two transplant centers in Hong Kong over two decades. RESULTS: 23 (1.9%) patients developed PTLD...
June 30, 2017: Oncotarget
https://www.readbyqxmd.com/read/28667038/post-transplant-lymphoproliferative-disorder-presented-in-a-form-of-primary-effusion-lymphoma-with-t-8-14
#11
Sadia Sultana, Suhair Al Salihi, Nidhi Tandon, Jesse Jaso, Nghia D Nguyen, Songlin Zhang, Jing Liu
Post-transplant lymphoproliferative disorders (PTLD) are emergent complications of organ transplantation occurring in 2% to 10% of transplanted patients. Epstein-Barr virus (EBV) infections are considered the most important factors for the development of these heterogeneous disorders. Primary effusion lymphoma (PEL) is a lymphoproliferative disorder predominantly described in patients with advanced AIDS and it is almost universally associated with human herpesvirus 8 (HHV8). In rare case, PEL also occurs in HHV8-negative patient, in the setting of hepatitis B and C virus infection...
May 2017: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/28653462/no-effect-of-treatment-with-intravenous-ganciclovir-on-epstein-barr-virus-viremia-demonstrated-after-pediatric-liver-transplantation
#12
Anniken B Østensen, Truls Sanengen, Ellen Holter, Pål-Dag Line, Runar Almaas
EBV after pediatric LT is a risk factor for PTLD. We wanted to evaluate the effect of intravenous ganciclovir on EBV viremia and to identify risk factors for chronic EBV viremia. All pediatric patients who underwent LT in Norway from 2002 until 2015 were reviewed. Twenty-two of 38 patients with viremia were treated with intravenous ganciclovir for a median of 22 (21-38) days. Treated and untreated patients were not different with respect to EBV seroconversion prior to transplantation or age at transplantation, but treated patients had significantly earlier viremia after transplantation (P=...
September 2017: Pediatric Transplantation
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
#13
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...
September 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28581032/preemptive-therapy-with-rituximab-for-epstein-barr-virus-reactivation-after-haplo-hsct
#14
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/28556519/lessons-learned-early-termination-of-a-randomized-trial-of-calcineurin-inhibitor-and-corticosteroid-avoidance-using-belatacept
#15
K A Newell, A K Mehta, C P Larsen, P G Stock, A B Farris, S G Mehta, D Ikle, B Armstrong, Y Morrison, N Bridges, M Robien, R B Mannon
The intent of this National Institutes of Health-sponsored study was to compare a belatacept-based immunosuppressive regimen with a maintenance regimen of tacrolimus and mycophenolate. Nineteen primary, Epstein-Barr virus-immune renal transplant recipients with a negative cross-match were randomized to one of three groups. All patient groups received perioperative steroids and maintenance mycophenolate mofetil. Patients in groups 1 and 2 were induced with alemtuzumab and maintained on tacrolimus or belatacept, respectively...
May 28, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28535360/posttransplant-lymphoproliferative-disorder-otolaryngological-manifestations-and-management
#16
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
#17
Jillian SY Lau, Zhi Mei Low, Iain Abbott, Lani Shochet, John Kanellis, Arthur Richard 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/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
#18
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)...
September 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28489256/clinical-and-virologic-outcomes-in-high-risk-adult-epstein-barr-virus-mismatched-organ-transplant-recipients
#19
Deepali Kumar, Nikhil Patil, Shahid Husain, Cecilia Chaparro, Mamatha Bhat, S Joseph Kim, Atul Humar
Epstein-Barr virus (EBV) D+/R- organ transplant recipients are a high-risk group for developing post-transplant lymphoproliferative disease (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...
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
#20
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
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