@article {4496, title = {Delayed seroconversion and rapid onset of lymphoproliferative disease after transmission of human T-cell lymphotropic virus type 1 from a multiorgan donor.}, journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America// Clin Infect Dis}, volume = {57}, year = {2013}, note = {Comment in: Clin Infect Dis. 2013 Nov;57(10):1425-6; PMID: 23956172}, month = {2013//}, pages = {1417 - 24}, address = {United States}, abstract = {BACKGROUND: Human T-cell lymphotropic virus type 1 (HTLV-1) screening of blood and organ donors is not mandatory in Germany because of its low prevalence (about 7/100 000). An HTLV-1 transmission event caused by a multiple organ donor was investigated. Validity of diagnostic procedures and HTLV-1 disease association in immunosuppressed organ recipients were analyzed., METHODS: Two screening immunoassays and an immunoblot (confirmatory assay) were used for detection of HLTV-1/2 antibodies. Proviral DNA was quantified in blood and biopsies of organ recipients by HTLV-1 real-time polymerase chain reaction (PCR)., RESULTS: Proviral HTLV-1-DNA was detected in all blood samples of 3 organ recipients (1-100 copies/10(2) cells), but seroconversion was delayed for up to 2 years in screening assays and >6 years in the confirmatory assay. In 2 of 3 organ recipients, a cutaneous T-cell lymphoma was diagnosed 2 and 3 years after infection, respectively. Proviral HTLV-1 DNA concentration was almost 100 copies/10(2) cells in cutaneous lymphoma biopsies whereas in biopsies of other tissues <3.0 copies/10(2) cells were found. The third organ recipient did not suffer from lymphoma, but detailed clinical data on this patient were not available to us., CONCLUSIONS: Biopsy results support an etiological role for HTLV-1 in these cases of primary cutaneous T-cell lymphoma after solid organ transplant. HTLV-1-associated lymphoma can arise quickly in immunocompromised transplant recipients. The diagnosis of potentially HTLV-1-associated disease in organ recipients may require PCR because of delayed seroconversion.}, keywords = {*Antibodies, Viral/bl [Blood], *HTLV-I Infections/vi [Virology], *Human T-lymphotropic virus 1/ip [Isolation \& Purification], *Lymphoma/vi [Virology], *Transplantation/ae [Adverse Effects], DNA, Viral/an [Analysis], Female, HTLV-I Infections/bl [Blood], Humans, Lymphoma/bl [Blood], Male, Middle Aged, Skin/ch [Chemistry], Skin/im [Immunology], Tissue Donors}, isbn = {1537-6591}, author = {Glowacka, Ilona and Korn, Klaus and Potthoff, Sebastian A and Lehmann, Ulrich and Kreipe, Hans H and Ivens, Katrin and Barg-Hock, Hannelore and Schulz, Thomas F and Heim, Albert} }