Enter your Email address:
Wolters Kluwer Health may email you for journal alerts and information, but is committed
to maintaining your privacy and will not share your personal information without
You currently have no recent searches
Jankowska, I.1; Paw owska, J.13; Kaliciñski, P.2; Teisseyre, M.1; Czubkowski, P.1; Gliwicz, D.1; Dura, W.3; Kamiñski, A.2; Markiewicz, M.2; Socha, J.1
1Gastroenterology, Hepatology and Immunology, 2Pediatric Surgery and Organ Transplatation, 3Pathology, Children’s Memorial Health Institute, Warsaw, Poland
Submitted by: firstname.lastname@example.org
Introduction: Posttransplant lymphoproliferative disease (PTLD) in children remains a significant clinical problem.
Methods: 156 pediatric liver transplantations were performed between March 1990 and December 2002 in Children’s Memorial Health Institute. Five of the children aged 18–29 months experienced EBV-associated PTLD. Recipients’ age at the time of transplantation ranged from 12 to 17 months. PTLD was diagnosed within 3 to 13 months after transplantation. The immunosuppressive regimen of all patients with PTLD consisted of prednisone and tacrolimus. Four pts had EBV VCA IgG before Ltx.
Results: The following signs and symptoms were observed: anemia (5), fever (4), hypoalbuminemia (3), anorexia (2), chronic diarrhea (3), values of EBV PCR genomes/105 lymphocytes ranged 400–5000 /N300 – University of Pittsburgh/ (5), biopsies of the lymph nodes revealed two types of histology: plasmacytic hyperplasia (2) and polymorphic B-cell infiltration (3).
Patients were treated with immunosuppression withdrawal (4) or reduction (1) and intravenous antiviral therapy. In one case anti-CD20 monoclonal antibody (rituximab) was given intravenously eight weeks after the onset of the disease. Clinical improvement and EBV-PCR reduction were observed in all patients. All children developed acute liver graft rejection episodes, confirmed by liver histology - tacrolimus therapy was then reintroduced. One patient had reccurence of PTLD 34 months after the first episode. The duration of follow-up after the onset of PTLD is 9–39 months. All children are alive.
Conclusion: PTLD is an important complication of immunosuppressive therapy, usually encountered in younger children after LTx.
In case of non-specific signs/symptoms further PTLD tests should be considered.
Reduction of immunosuppression is an effective therapy but must be administered cautiously regarding the acute rejection risk.
© 2004 Lippincott Williams & Wilkins, Inc.
Colleague's E-mail is Invalid
Your Name: (optional)
Separate multiple e-mails with a (;).
Thought you might appreciate this item(s) I saw at Journal of Pediatric Gastroenterology and Nutrition.
Send a copy to your email
Your message has been successfully sent to your colleague.
Some error has occurred while processing your request. Please try after some time.
An Existing Folder
A New Folder
The item(s) has been successfully added to "".
Login with your LWW Journals username and password.
Username or Email:
Enter and submit the email address you registered with. An email with instructions to reset your password will be sent to that address.
Link to reset your password has been sent to specified email address.
What does "Remember me" mean?
By checking this box, you'll stay logged in for
days or until you logout. You'll get easier access to your articles, collections,
media, and all your other content, even if you close your browser or shut down your
To protect your most sensitive data and activities (like changing your password),
we'll ask you to re-enter your password when you access these services.
What if I'm on a computer that I share with others?
If you're using a public computer or you share this computer with others, we recommend
that you uncheck the "Remember me" box.
Save my selection
Visit JPGN.org on your smartphone. Scan this code (QR reader app required) with your phone and be taken directly to the site.