Epstein-Barr Virus Infection in Transplant Recipients: Sumary of a Workshop on Surveillance, Prevention and Treatment

Allen, Upton; Alfieri, Caroline; Preiksaitis, Jutta K.; Humar, Atul; Moore, Dorothy; Tapiéro, Bruce; Tellier, Raymond; Green, Michael; Davies, D. A. R.; Hébert, Diane; Weitzman, Sheila; Petric, Martin; Jacobson, Kevan

doi:10.1155/2002/634318

Cited by 47 publications

(38 citation statements)

References 54 publications

(63 reference statements)

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“…Most of PTLD are of B cell in origin and EBV is present in majority. 81,82 EBV negative PTLD is associated with later onset, monomorphic histology and aggressive clinical behavior similar to lymphomas in immuno competent patients. 83 Risk factors for PTLD include Epstein-Barr virus seronegativity at transplant, younger age, intensity of immunosuppression and the first year posttransplant.…”

Section: Development Of De Novo Malignancies and Posttransplant Lymphmentioning

confidence: 99%

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Current Status of Immunosuppression in Liver Transplantation

Choudhary

Saigal

Shukla

et al. 2013

Journal of Clinical and Experimental Hepatology

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With advancements in immunosuppressive strategies and availability of better immunosuppressive agents, survival rate following liver transplantation has improved significantly in the recent times. Besides improvements in surgical techniques, the most important factor that has contributed to this better outcome is the progress made in the field of immunosuppression. Over the last several years, the trend has changed to tailored immunosuppression with the aim of achieving optimal graft function while avoiding its undesirable side effects. Induction agents are no longer used routinely and the aim is to provide minimal immunosuppression in the maintenance phase. The present review discusses the various types of immunosuppressive agents, their mechanism of action, clinical utility, advantages and disadvantages, and their side effects in short and long-term. It also discusses about tailoring immunosuppression in presence of various situations such as renal dysfunction, metabolic syndrome, hepatitis C recurrence, cytomegalovirus infections and so on. The issue of chronic kidney disease and the available renal sparing immunosuppressive strategies has been particularly stressed upon. Finally, it discusses about the practical aspects of various immunosuppression regimens including drug monitoring. ( J CLIN EXP HEPATOL 2013;3:150-158)

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Section: Development Of De Novo Malignancies and Posttransplant Lymphmentioning

confidence: 99%

“…In patients diagnosed with PTLD, management options include reduction of immunosuppression, rituximab, combination chemotherapy, and adoptive immunotherapy. 81,82 Steroid Free Immunosuppression…”

Section: Development Of De Novo Malignancies and Posttransplant Lymphmentioning

confidence: 99%

Current Status of Immunosuppression in Liver Transplantation

Choudhary

Saigal

Shukla

et al. 2013

Journal of Clinical and Experimental Hepatology

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“…Monomorphic B cell PTLD is the most frequent variant, especially diffuse large B cell lymphomas (21,22). In our cases, 60% of patients had monomorphic B cell lymphoma, of which 50% were diffuse large B cell variant.…”

Section: Ptld Diagnosismentioning

confidence: 46%

Post-transplant lymphoproliferative disease in liver transplant recipients

et al. 2017

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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.Results: PTLD incidence was 1.2% (10/851). The mean time from liver transplantation to PTLD diagnosis was 36 months (range 1.2 to 144 months). PTLD localization was extranodal in all cases, the most frequent location being intestinal. Seven cases showed a monomorphic lymphoma which in all cases was differentiated B cell lymphomas. Fifty per cent of the series were seropositive for Epstein-Barr virus. Five patients were alive at the time of the review. Among these patients, we observed three cases of complete remission and two cases of disease stabilization. The death rate was higher in the first year after diagnosis of PTLD.Conclusion: PTLD is a rare complication after liver transplantation, but it may pose a threat to the life of a liver transplant recipient. It is essential to identify patients at risk, to establish an early diagnosis and treatment that can change the outcome of the disease.

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“…(GRADE C1) 217 Enfermedad linfoproliferativa por enfermedad de Epstein-Barr postrasplante de órganos sólidos La enfermedad linfoproliferativa puede ocurrir hasta en 16 % de los receptores de trasplante de órgano sólido y es más frecuente en los pacientes seronegativos para virus de Epstein-Barr con donantes seropositivos, ya que hasta en 70 % de los casos este virus contribuye en la patogénesis. 48,218,219,220,221,222 R Se sugiere disminuir la inmunosupresión con el uso concomitante de antiviral con acción contra los virus herpes.…”

Section: Síndrome De Rassmussenunclassified

“…El más recomendado hasta el momento es valganciclovir, así como los anticuerpos monoclonales contra linfocitos B infectados (rituximab) y la IgIV. (GRADE B1) 217,218,223 R Se ha reportado que la IgIV es útil en conjunto con rituximab y ganciclovir o su prodroga valganciclovir. Se recomienda administrar 2 g/kg de IgIV, divididos en una o dos aplicaciones.…”

Section: Síndrome De Rassmussenunclassified

Guía colombiana de práctica clínica para el uso de inmonuglobulinas en el tratamiento de reemplazo e inmunomodulación

Olivares

Olmos²,

Álvarez

et al. 2017

RAM

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Immunoglobulins are heterodimeric proteins composed of 2 heavy chains and 2 light chains. Human immunoglobulin G (IgG) is a plasma derivative and contains more than 95% of IgG. The composition of IgG subclasses is similar to that of normal human plasma. Immunoglobulin therapy was first introduced more than 50 years ago, and its use has been described in numerous diseases. In Colombia, the importance of this immunomodulatory resource prompted the need for clinical practice guidelines to be available for its use. For this reason, a multidisciplinary group of experts was brought together and distributed in working groups, by specialties, in order to develop an initial manuscript. Systematic literature searches were undertaken; identified evidences were evaluated and classified to support a preliminary draft that was discussed, analyzed and amended. Recommendations were issued on the use of intravenous immunoglobulin in pathologies that include primary and secondary immunodeficiencies, autoimmune diseases, neurological disorders, infections, transplants and miscellaneous conditions; grades were assigned to each one of them according to the GRADE system. The final result translated into recommendations that are put forth with the purpose to inform, guide and support on optimal use of this immunomodulatory resource.

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Epstein-Barr Virus Infection in Transplant Recipients: Sumary of a Workshop on Surveillance, Prevention and Treatment

Cited by 47 publications

References 54 publications

Current Status of Immunosuppression in Liver Transplantation

Current Status of Immunosuppression in Liver Transplantation

Post-transplant lymphoproliferative disease in liver transplant recipients

Guía colombiana de práctica clínica para el uso de inmonuglobulinas en el tratamiento de reemplazo e inmunomodulación

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