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Ptld liver transplant

Lila Simakachorn, Pornthep Tanpowpong, Chatmanee Lertudomphonwanit, Usanarat Anurathapan, Samart Pakakasama, Suradej Hongeng, Suporn Treepongkaruna, Pornpimon Phuapradit
PTLD is a rare but potentially life-threatening condition, which shows a higher prevalence in children than in adults. From 129 children who underwent LT, we reported 5 cases with biopsy-proven PTLD at a single teaching hospital. Four patients had shared clinical presentations including fever, lymphadenopathy, and splenomegaly. They were noted to be given a prolonged course of IS due to the management of comorbid complications such as acute cellular rejection or severe food allergy or eosinophilic gastrointestinal disease...
January 20, 2019: Pediatric Transplantation
Chien-Ting Hsu, Mei-Hwei Chang, Ming-Chih Ho, Hsiu-Hao Chang, Meng-Yao Lu, Shiann-Tarng Jou, Yen-Hsuan Ni, Huey-Ling Chen, Hong-Yuan Hsu, Jia-Feng Wu
BACKGROUND: Post-transplantation lymphoproliferative disorder (PTLD) is a heterogeneous, potentially life-threatening complication after liver transplantation in children. In this study, the disease characteristics, outcomes, and prognostic factors of PTLD were investigated. METHODS: A retrospective, observational study was conducted on 16 pediatric liver transplant (LT) recipients who developed PTLD between February 2001 and December 2013 at a tertiary referral center in Taiwan...
January 8, 2019: Journal of the Formosan Medical Association
Ho-Sheng Chen, Ming-Chih Ho, Rey-Heng Hu, Jia-Feng Wu, Huey-Ling Chen, Yen-Hsuan Ni, Hong-Yuan Hsu, Yung-Ming Jeng, Mei-Hwei Chang
BACKGROUND/PURPOSE: This study is aimed to investigate the risk factors and clinical characteristics of posttransplant lymphoproliferative disorder (PTLD) after conducting Epstein-Barr virus (EBV) viral load monitoring in pediatric liver transplant (LT) patients in Taiwan, where EBV infection is endemic. METHODS: From 2007 to 2013, pediatric LT recipients who underwent EBV viral load monitoring within 3 months after LT were recruited in this study. The impact of clinical parameters-including age at LT, sex, peak EBV viral load and immunosuppressant levels after LT-on the risk of PTLD were assessed...
January 3, 2019: Journal of the Formosan Medical Association
S Mizuno, A Hayasaki, T Ito, T Fujii, Y Iizawa, H Kato, Y Murata, A Tanemura, N Kuriyama, Y Azumi, M Kishiwada, M Usui, H Sakurai, S Isaji
OBJECTIVE: In patients with living donor liver transplantation (LDLT), late-onset complications sometimes develop because of long-term use of immunosuppressive drugs. One of the immunosuppressive drug-related complications is de novo malignancies resulting in reduced survival. PATIENTS AND METHODS: Among 153 patients undergoing LDLT, we retrospectively reviewed the medical records of 97 adult recipients (February 2002 to May 2017), who had been followed-up at our hospital for more than one year after LDLT...
November 2018: Transplantation Proceedings
Fan Yu, Yuehua Huang, Yanying Wang, Zhuo Yu, Xinquan Li, Jiahong Dong
RATIONALE: Post transplantation lymphoproliferative disorder (PTLD) is a rare but severe complication. Epstein-Barr virus (EBV) is considered an important pathogen for PTLD and EBV deoxyribonucleic acid (DNA) load is widely monitored to detect PTLD early. Hepatitis B virus (HBV) infection is rarely reported to be related with PTLD. We report a case of EBV negative (EBV), HBV positive (HBV) diffuse large B cell lymphoma in a patient 12 years after liver transplantation. PATIENT CONCERNS AND DIAGNOSIS: A 52-year-old man complained of worsening appetite, abdominal distension, and pruritus...
November 2018: Medicine (Baltimore)
M Wójciak, J Gozdowska, D Dęborska-Materkowska, A Perkowska-Ptasińska, M Kosieradzki, S Nazarewski, M Durlik
INTRODUCTION: Posttransplant lymphoproliferative disorder (PTLD) is a heterogeneous group of lymphoid malignant neoplasms arising after solid organ transplantation or hematopoietic stem cell transplantation. The current World Health Organization classification identified 4 basic histologic types of PTLD: early, polymorphic variant, monomorphic variant, and classical Hodgkin lymphoma-type lesions. METHODS: Data of 12 PTLD cases of was retrospectively analyzed in terms of the transplanted organs, time to diagnosis of PTLD, type of immunosuppressive treatment in regard to the induction treatment and acute transplant rejection, and long-term survival...
September 2018: Transplantation Proceedings
Eric A Engels, Linda W Jennings, Matthew J Everly, Ola Landgren, Kazunori Murata, Elizabeth L Yanik, Ruth M Pfeiffer, Nicholas Onaca, Goran B Klintmalm
Background: Posttransplant lymphoproliferative disorder (PTLD) is a neoplastic complication of transplantation, with early cases largely due to immunosuppression and primary Epstein-Barr virus infection. Etiology may differ for later-onset cases, but the contributions of immunosuppression, immune reactivity to the donor organ, and chronic B cell activation are uncertain. Methods: We conducted a case-control study of late-onset PTLD (diagnosed >1 year posttransplant) in a cohort of liver recipients...
June 2018: Transplantation Direct
Carmen Bernal Bellido, Gonzalo Suárez Artacho, José María Álamo Martínez, Luis Miguel Marin Gómez, Carmen Cepeda Franco, Lydia Barrera Pulido, Juan Manuel Praena Fernández, Javier Padillo Ruiz, Miguel Ángel Gómez Bravo
INTRODUCTION: The greater survival of transplanted patients is accompanied by an increase in the rate of de novo malignancies (NM), which are the most frequent late-onset complication. We can distinguish between non-melanoma skin cancers (NMSC), post-transplant lymphoproliferative disorders (PTLD) and solid organ cancers (SOC). Our objective is to determine the incidence of the different types of NM, the time elapsed until diagnosis and survival rates in our setting. METHODS: We conducted a retrospective study of 1071 liver transplant patients from 1990 to 2015 at our center...
July 12, 2018: Cirugía Española
Rebecca E Schultze-Florey, Sabine Tischer, Leonie Kuhlmann, Patrick Hundsdoerfer, Arend Koch, Ioannis Anagnostopoulos, Sarina Ravens, Lilia Goudeva, Christian Schultze-Florey, Christian Koenecke, Rainer Blasczyk, Ulrike Koehl, Hans-Gert Heuft, Immo Prinz, Britta Eiz-Vesper, Britta Maecker-Kolhoff
Epstein-Barr virus (EBV)-associated posttransplant lymphoproliferative disease (PTLD) with central nervous system (CNS) involvement is a severe complication after solid organ transplantation. Standard treatment with reduction of immunosuppression and anti-CD20 antibody application often fails leading to poor outcome. Here, we report the case of an 11-year-old boy with multilocular EBV-positive CNS PTLD 10 years after liver transplantation. Complete remission was achieved by repeated intravenous and intrathecal anti-CD20 antibody rituximab administration combined with intrathecal chemotherapy (methotrexate, cytarabine, prednisone) over a time period of 3 months...
2018: Frontiers in Immunology
Hiroyuki Kumata, Chikashi Nakanishi, Keigo Murakami, Shigehito Miyagi, Noriko Fukuhara, Joaquim Carreras, Naoya Nakamura, Ryo Ichinohasama, Michiaki Unno, Takashi Kamei, Hironobu Sasano
BACKGROUND: Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication that can be difficult to treat; moreover, determination of the pathophysiological type is difficult. We report a rare case of a patient who developed two types of Epstein-Barr virus (EBV)-negative PTLD following living donor liver transplantation (LDLT). CASE PRESENTATION: A 64-year-old man underwent LDLT for acute fulminant hepatitis B. Sixty-five months later, he developed EBV-negative monomorphic B cell PTLD...
July 6, 2018: Surgical Case Reports
Samuel Romero, Juan Montoro, Marta Guinot, Luis Almenar, Rafael Andreu, Aitana Balaguer, Isabel Beneyto, Jordi Espí, José Gómez-Codina, Gloria Iacoboni, Isidro Jarque, Rafael López-Andújar, Empar Mayordomo-Aranda, Joaquín Montalar, Amparo Pastor, Miguel Pastor, José L Piñana, Nohelia Rojas-Ferrer, Ignacio Sánchez-Lázaro, Jesús Sandoval, Guillermo Sanz, Miguel Á Sanz, Amparo Solé, Jaime Sanz
Post-transplant lymphoproliferative disorders (PTLD) are a rare complication after both solid organ (SOT) and allogeneic hematopoietic stem cell transplantation (allo-HSCT). In this single center retrospective study, we compared clinical, biological, and histological features, and outcomes of PTLD after both types of transplant. We identified 82 PTLD (61 after SOT and 21 after allo-HSCT). The presence of B symptoms, Waldeyer ring, spleen, central nervous system, and liver involvement, and advanced Ann-Arbor stage were more frequent in allo-HSCT recipients...
July 3, 2018: Leukemia & Lymphoma
Rebecca Epperly, John Ozolek, Kyle Soltys, Debra Cohen, Rakesh Goyal, Erika Friehling
Post-transplant lymphoproliferative disorder (PTLD) related plasma cell neoplasms are rare in pediatric patients. We report a pediatric liver transplant recipient with plasma cell myeloma type PTLD. Cytogenetics included 1q duplication, associated with poor prognosis in adult multiple myeloma, and t(8;14). High-risk cytogenetics has not been reported in pediatric plasma cell myeloma type PTLD. The patient was treated with bortezomib, dexamethasone, and lenalidomide with subsequent autologous stem cell transplant...
October 2018: Pediatric Blood & Cancer
Ravish Parekh, Ahmed Abdulhamid, Sheri Trudeau, Nirmal Kaur
Background: Outcome data regarding the use of tumor necrosis factor alpha inhibitors (anti-TNF α ) in patients with inflammatory bowel disease (IBD) after liver transplant (LT) for primary sclerosing cholangitis (PSC) are scant. Methods: We performed a retrospective chart review to investigate outcomes among a series of post-liver-transplant PSC/IBD patients receiving anti-TNF α therapy at Henry Ford Health System ((HFHS), Detroit, MI). Results: A total of five patients were treated with anti-TNF α agents for IBD after LT for PSC from 1993 through 2015...
2018: Case Reports in Gastrointestinal Medicine
Zeren Barış, Figen Özçay, Özlem Yılmaz Özbek, Nihan Haberal, Faik Sarıalioğlu, Mehmet Haberal
BACKGROUND/AIMS: We evaluated our 16-year single-center experience of pediatric post-transplant lymphoproliferative disorder (PTLD) cases who underwent liver transplantation between 2001 and 2017. MATERIALS AND METHODS: Of the 236 pediatric patients who underwent liver transplantation between 2001 and 2017, the clinical and laboratory data of eight patients diagnosed with PTLD were reviewed. The pre-transplant Epstein-Barr virus (EBV) status of 172 patients was also recorded...
May 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Ahmed Abu-Shanab, Yasser Ged, Naeem Ullah, Diarmaid Houlihan, Aiden McCormick
Background: Post-Transplant Lymphoproliferative Disorder (PTLD) is a well-recognized complication post solid organs transplant. PTLD represents a broad spectrum of abnormalities ranging from an infectious mononucleosis like illness to malignant lymphoma. Methods: A retrospective study was performed by collecting data of orthotopic liver transplant (OLT) patients in the National Liver Unit in Ireland from December 1993 to December 2014. Data was analyzed to identify PTLD patients and determine their demographic details, the indication for liver transplant, presenting symptoms, immunosuppression regimens, Epstein"Barr virus (EBV) status and PTLD outcome...
March 2018: Journal of Clinical and Experimental Hepatology
Jianming Li, Yujiang Liu, Zhenchang Wang, Xiangdong Hu, Ruifang Xu, Linxue Qian
RATIONALE: Among patients with post-transplant lymphoproliferative disorder (PTLD), there is a high incidence of immunosuppressed transplant recipients. It is necessary to make an early diagnosis to increase the likelihood of a good prognosis. PATIENT CONCERNS: We report a case of a 54-year-old female patient who developed PTLD after liver and kidney transplantation. DIAGNOSES: We aimed to analyze the standard diagnosis and follow-up of PTLD with imaging...
April 2018: Medicine (Baltimore)
Harpreet Singh Grewal, Charles Lane, Kristin B Highland, Olufemi Akindipe, Marie Budev, Atul C Mehta
Post-transplant lymphoproliferative disorder (PTLD) occurs in ~5% of solid organ and hematopoietic stem cell transplant recipients. We report a unique presentation of PTLD in the bladder of a lung transplant recipient. Our patient was a 62-year-old female who received a bilateral lung transplant for chronic obstructive pulmonary disease. She presented with fever, left-sided flank pain and foul-smelling urine consistent with urosepsis. An abdominal and pelvic computerized tomography revealed an irregular and nodular bladder wall thickening suspicious for urothelial neoplasm...
March 2018: Oxford Medical Case Reports
Faisal Inayat, Ghias Ul Hassan, Ghias Un Nabi Tayyab, Muhammad Wasif Saif
Post-transplantation lymphoproliferative disorders (PTLDs) are lymphoid proliferations or lymphomas that are the second most common tumors in adult transplant recipients. Most cases of PTLD are attributed to Epstein-Barr virus, which induces B-cell proliferation and occurs in the setting of severe immunosuppression after solid organ or bone marrow transplantation. The disorder is seen in 1-3% of liver transplant recipients and has a variable presentation chronology. Herein, we chronicle a case of aggressive B-cell lymphoma (PTLD WHO class-3) presenting with isolated gastrointestinal involvement in an Epstein-Barr virus-negative patient with living-donor liver transplantation, 4 years after receiving the transplant...
March 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Tara T Ghaziani, Joy J Liu, Zhenghui G Jiang, Imad Nasser, Khalid Khwaja, Robert A Fisher, Myrna Nahas, Michael P Curry
Posttransplant lymphoproliferative disorder (PTLD) is a serious complication that accounts for up to 20% of malignancies after solid organ transplantation. We describe a rare case of isolated PTLD in the adrenal gland occurring 7 months after liver transplant in a patient who developed a primary Epstein-Barr virus infection. He was treated with rituximab and his immunosuppression regimen was minimized. We review the incidence, pathogenesis, presentation, and management of PTLD in the liver-transplant population...
2018: ACG Case Reports Journal
Chandrashekhar A Kubal, Catherine Pennington, Jonathan Fridell, Burcin Ekser, Plamen Muhaylov, Richard Mangus
BACKGROUND Patients undergoing re-transplantation often receive high doses of immunosuppression, which may lead to an immunocompromised status of the recipient. This study investigates the outcomes after intestine/multivisceral re-transplantation. MATERIAL AND METHODS Clinical outcomes of 23 patients undergoing 24 re-transplantations at a single intestine transplant center were reviewed. Bone marrow suppression was used as a surrogate marker of immunocompromised status, and was defined as platelet count <50 k/mm3 and absolute lymphocyte count <200/mm³...
February 6, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
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