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Clinical imaging and pathology analysis of Epstein-Barr virus-associated monomorphic lymphoproliferative disease after liver transplantation in children-a retrospective case series.
Transl Pediatr
December 2024
Department of Hematology, Chongqing Medical University Affiliated Children's Hospital, Chongqing, China.
Background: Post-transplant lymphoproliferative disease (PTLD) is a significant complication that can arise following solid organ transplantation or hematopoietic stem cell transplantation. It encompasses a spectrum of lymphoproliferative lesions, ranging from benign reactive hyperplasia to malignant tumors, and is among the most severe complications following liver transplantation in children. It is essential for clinicians to gain a comprehensive understanding of the prevention, clinical manifestations, early diagnosis, and treatment strategies for PTLD in order to reduce mortality rates.
View Article and Find Full Text PDFEnhanced Costimulation Blockade With αCD154, αCD2, and αCD28 to Promote Heart Allograft Tolerance in Nonhuman Primates.
Transplantation
January 2025
Department of Surgery, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Background: Long-term renal allograft acceptance has been achieved in macaques using a transient mixed hematopoetic chimerism protocol, but similar regimens have proven unsuccessful in heart allograft recipients unless a kidney transplant was performed simultaneously. Here, we test whether a modified protocol based on targeting CD154, CD2, and CD28 is sufficient to prolong heart allograft acceptance or promote the expansion of regulatory T cells.
Methods: Eight macaques underwent heterotopic allo-heart transplantation from major histocompatibility complex-mismatched donors.
Dynamic Presentations of Recurrent Post-Transplant Lymphoproliferative Disorder in a Heart Transplant Recipient: A Rare Case Study.
ACG Case Rep J
November 2024
Division of Gastroenterology, Henry Ford Hospital, Detroit, MI.
Post-transplant lymphoproliferative disorders (PTLD) are complications that arise from post-transplantation immunosuppressive therapy. Although Epstein-Barr virus (EBV) viremia is often seen in PTLD, it is not a definitive feature for diagnosis. We report a rare case of recurrent PTLD in a 26-year-old heart transplant recipient on high-dose tacrolimus who presented with emesis, fatigue, and bloody diarrhea.
View Article and Find Full Text PDFIncreased Epstein‒Barr virus reactivation following prophylaxis for cytomegalovirus infection after haploidentical haematopoietic stem cell transplantation.
J Hematol Oncol
October 2024
National Clinical Research Center for Hematologic Diseases, the First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.
Article Synopsis
- Letermovir (LTV) prophylaxis significantly reduces the incidence of clinically significant cytomegalovirus (CMV) infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT).
- A study of 230 patients показал that those receiving LTV experienced a higher rate of Epstein-Barr virus (EBV) reactivation (27%) compared to those who did not receive LTV (13%).
- Despite the increased EBV reactivation, there were no major differences in recovery metrics, overall survival, or other complications between the LTV and control groups, suggesting a possible link between LTV use and increased EBV reactivation post-transplant.
Prevention of post-transplant lymphoproliferative disorder in pediatric kidney transplant recipients.
Pediatr Nephrol
March 2025
Technion Faculty of Medicine, Haifa, Israel.
Article Synopsis
- Post-transplant lymphoproliferative disorder (PTLD) often occurs in patients who have undergone organ or stem cell transplants and is linked to Epstein-Barr virus (EBV) infection, which precedes PTLD in 90% of cases.
- A study involved pediatric kidney transplant recipients (PKTR) who were monitored for EBV through blood tests, and those with rising viral loads despite lowering immunosuppressive drugs were given preventive rituximab therapy.
- Results showed that rituximab was effective in clearing EBV from patients who struggled to respond to other treatments, suggesting that it may be a safe option for preventing PTLD in high-risk pediatric kidney transplant patients.
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