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Titolo:
POSTTRANSPLANT LYMPHOPROLIFERATIVE DISORDERS AND GASTROINTESTINAL MANIFESTATIONS OF EPSTEIN-BARR-VIRUS INFECTION IN CHILDREN FOLLOWING LIVER-TRANSPLANTATION
Autore:
CAO S; COX K; ESQUIVEL CO; BERQUIST W; CONCEPCION W; OJOGHO O; MONGE H; KRAMS S; MARTINEZ O; SO S;
Indirizzi:
LOMA LINDA UNIV,MED CTR,INST TRANSPLANTAT,11234 ANDERSON ST,ROOM 1405,POB 2000 LOMA LINDA CA 92354 STANFORD UNIV,MED CTR,DEPT SURG,DIV LIVER TRANSPLANT PALO ALTO CA 94304 STANFORD UNIV,MED CTR,DEPT PEDIAT,DIV LIVER TRANSPLANT PALO ALTO CA 94304
Titolo Testata:
Transplantation
fascicolo: 7, volume: 66, anno: 1998,
pagine: 851 - 856
SICI:
0041-1337(1998)66:7<851:PLDAGM>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
INVOLVEMENT; RECIPIENTS; FK-506; FK506; ASSAY; TRACT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
19
Recensione:
Indirizzi per estratti:
Citazione:
S. Cao et al., "POSTTRANSPLANT LYMPHOPROLIFERATIVE DISORDERS AND GASTROINTESTINAL MANIFESTATIONS OF EPSTEIN-BARR-VIRUS INFECTION IN CHILDREN FOLLOWING LIVER-TRANSPLANTATION", Transplantation, 66(7), 1998, pp. 851-856

Abstract

Background. Epstein-Barr virus (EBV) infection is common after liver transplantation in children and associated with the risk of posttransplant lymphoproliferative disorders (PTLD). Methods. This retrospectivestudy examined the frequency of gastrointestinal (GI) symptoms and the risk of PTLD in pediatric liver recipients who developed symptomaticEBV infection. We reviewed 172 children who received orthotopic livertransplants between March 1988 to December 1994. Twenty-two cases were retransplants. The mean age at transplantation was 3.7 years (range,0.1-17 years). The immunosuppressive regimens consisted of induction therapy with Minnesota antilymphocyte globulin/antithymocyte globulin/OKT3 in most cases and maintenance therapy with prednisone and either cyclosporine or tacrolimus (FK506). Results. After 1 year of minimum follow-up, 54 of 172 patients had symptomatic EBV infections (confirmedby serology, histology, or whole blood polymerase chain reaction. At the time of infection, 38.5% (21/54) had either diarrhea or GI bleeding or both. PTLD developed in 11 patients (6.4%). The incidence of PTLDwas 42.9% (9/21) when GI bleeding or diarrhea was associated with EBVinfections, compared with 6.1% (2/33) when EBV infection was not associated with GI symptoms. Seven of 10 (70%) patients with GI bleeding and 2 of 11 (18.2%) with diarrhea developed PTLD. Of seven patients examined by endoscopy for GI bleeding, two had biopsy-proven PTLD of the GI tract, whereas one of two patients examined by endoscopy for diarrhea had biopsy-proven PTLD. Discussion. In summary, a high incidence ofPTLD was found in patients who developed GI bleeding or diarrhea associated with EBV infection after pediatric liver transplantation. In these patients, endoscopy and biopsy may lead to early diagnosis of PTLD.

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Documento generato il 15/07/20 alle ore 05:19:35