scholarly journals Idiopathic pulmonary fibrosis lung transplant recipients are at increased risk for EBV‐associated posttransplant lymphoproliferative disorder and worse survival

2020 ◽  
Vol 20 (5) ◽  
pp. 1439-1446
Author(s):  
Carlo J. Iasella ◽  
Spencer A. Winters ◽  
Abigail Kois ◽  
Jaehee Cho ◽  
Stefanie J. Hannan ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lymphoproliferative Disorder ◽  
Lung Transplant ◽  
Transplant Recipients ◽  
Posttransplant Lymphoproliferative Disorder ◽  
Increased Risk ◽  
Idiopathic Pulmonary Fibrosis Lung ◽  
Lung Transplant Recipients

Posttransplant Lymphoproliferative Disorder in Adult Lung Transplant Recipients: A Report on Twenty-Seven Patients.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4425-4425
Author(s):  
Sophie D. Stein ◽  
Jamal Misleh ◽  
Vivek Ahya ◽  
Robert Kotloff ◽  
Jason Christie ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Lymphoproliferative Disorder ◽  
Lung Transplant ◽  
Radiation Treatment ◽  
Case Series ◽  
Complete Response ◽  
Transplant Recipients ◽  
Posttransplant Lymphoproliferative Disorder ◽  
Primary Treatment Modality ◽  
Lung Transplant Recipients

Abstract Posttransplant lymphoproliferative disorder (PTLD) is a serious complication of organ transplantation. We report a case series on the diagnosis, treatment and outcome of PTLD in lung transplant recipients. From 1991 to 2006, 27 (5%) of the 502 lung transplant recipients at our institution developed PTLD. The median age at transplant was 51.5 years (range 21–65 years) and the median time from transplant to PTLD diagnosis was 33.7 months (range 1–174 months). Most cases had an elevated LDH (86%) and were EBV-positive (85%). Of the cases tested (n=14), 64% were monoclonal. PTLD was most commonly diagnosed in the lung (56%) and gastrointestinal tract (26%). Three patients were diagnosed at autopsy, while the remaining 24 received therapy. Eight patients were initially treated with reduced immunosuppression (RI) alone, but only 3 (38%) obtained a complete response (CR). Rituxan (R) was used alone (n=3) or in combination with RI (n=3) as initial therapy in six patients, four of whom obtained a CR. Five patients utilized RI +/− surgical resection as a primary treatment modality, all of whom achieved a CR. However, all of them relapsed and required further treatment. Of these five patients initially treated with RI +/− surgical resection, a CR was reestablished in 3 using rituxan alone (1/3), combined rituxan and reduced immunosuppression (1/3) and radiation treatment alone (1/3). The remaining five patients from the 24 patients receiving induction therapy for PTLD were given other treatments. With an average follow-up of 28 months (range 1-130 months), 81% of patients have died. However, only 18% of deaths were directly related to progressive PTLD. The remaining 17 deaths were due to: infection unrelated to PTLD treatment (15%), multi-organ failure (7%), graft failure not due to RI (30%), stroke (4%), and renal failure (4%). Most deaths can be attributed to disease specific and posttransplant complications rather than PTLD. Although an unfortunate diagnosis, PTLD is responsive to therapy, particularly reduced immunosuppression and rituximab.

scholarly journals Use of Foscarnet Therapy for EBV Infection following Control of PTLD with Enhancement of Cellular Immunity in a Lung-Transplant Recipient

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Kamyar Afshar ◽  
A. Purush Rao ◽  
Vipul Patel ◽  
Kevin Forrester ◽  
Sivagini Ganesh
Keyword(s):  
Lymphoproliferative Disorder ◽  
Lung Transplant ◽  
Strong Association ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Posttransplant Lymphoproliferative Disorder ◽  
Annual Incidence Rate ◽  
Ebv Infection ◽  
Lung Transplant Recipients

Posttransplant lymphoproliferative disorder (PTLD) is a serious complication following solid organ transplantation with an annual incidence rate of 3–5% in lung-transplant recipients. Pathogenesis indicates a strong association with functional over-immunosuppression and EBV infection. Clinical improvement is generally observed with reduction in immunosuppression intensity alone. We present a case of a 24-year-old woman with EBV-associated PTLD following lung transplant where decreasing the immunosuppression improved PTLD but was ineffective against controlling the EBV infection. Foscarnet in combination with immunoglobulins was successfully administered to cause a remission of the EBV infection. This is the second case reported of a persistent EBV infection after reducing immunosuppression levels and evidence of PTLD remission that required foscarnet for EBV infection control.

scholarly journals Progression of native lung fibrosis in lung transplant recipients with idiopathic pulmonary fibrosis

2010 ◽  
Vol 104 (3) ◽  
pp. 426-433 ◽  
Author(s):  
Brett M. Elicker ◽  
Jeffrey A. Golden ◽  
Karen G. Ordovas ◽  
Lorriana Leard ◽  
Todd R. Golden ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lung Fibrosis ◽  
Lung Transplant ◽  
Transplant Recipients ◽  
Native Lung ◽  
Lung Transplant Recipients
Sign in / Sign up

Export Citation Format

Share Document