Epstein-Barr virus-associated post-transplant lympho-proliferative disease of donor origin in liver transplant recipients

TitleEpstein-Barr virus-associated post-transplant lympho-proliferative disease of donor origin in liver transplant recipients
Publication TypeJournal Article
Year of Publication1997
AuthorsStrazzabosco M, Corneo B, Iemmolo RM, Menin C, Gerunda G, Bonaldi L, Merenda R, Neri D, Poletti A, Montagna M, Del Mistro A, Faccioli AM, D'Andrea E
JournalJ Hepatol
Pagination926 - 34
Date PublishedApr
ISSN0168-8278 (Print) 0168-8278 (Linking)
Accession Number9126809
Keywords*Herpesvirus 4, Human, *Tissue Donors, B-Lymphocytes / pathology, Cell Line, Herpesviridae Infections / *etiology / pathology / radiography, Humans, Liver Transplantation / *adverse effects, Lymphoproliferative Disorders / *etiology / genetics / *virology, Male, Microsatellite Repeats, Middle Aged, Tomography, X-Ray Computed, Tumor Virus Infections / *etiology / pathology / radiography

BACKGROUND/AIMS: Post-transplant lymphoproliferative disease, a potential complication of solid organ transplantation, occurs in about 3% of orthotopic liver transplant recipients. We report the genetic and virological characterization of two cases of post-transplant lymphoproliferative disease that occurred early (4 and 6 months) after orthotopic liver transplant as large-cell non-Hodgkin's lymphomas located at the hepatic hilum. METHODS: Lymphomatous tissues were analyzed for clonality and presence of Epstein-Barr virus (EBV) sequences by Southern blot, polymerase chain reaction, and in situ hybridization techniques. RESULTS: The tumors in both cases were sustained by a clonal proliferation of B lymphocytes containing type A EBV DNA. Moreover, in situ hybridization with a digoxigenin-labeled EBV-specific probe evidenced a strong nuclear signal in most of the neoplastic cells. DNA microsatellite analysis at three different loci detected alleles of donor origin in both tumor samples, suggesting that the neoplastic B cells were of donor origin. CONCLUSIONS: EBV-infected donor B lymphocytes might be responsible for intragraft post-transplant lymphoproliferative disease in orthotopic liver transplant recipients. As 20 to 30% of post-transplant lymphomas involve the graft itself, donor-derived post-transplant lymphoproliferative disease might be more frequent than presently appreciated. Prospective studies are needed to assess its real incidence and identify possible risk factors.

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