Post-transplant lymphoproliferative disease.

摘要: Post-transplant lymphoproliferative disease (PTLD) emerged in the mid-1990s as a major graft- and life-threatening complication of pediatric kidney transplantation. This condition, usually involving uncontrolled B lymphocyte proliferation, straddles border between infection malignancy, since Epstein-Barr virus (EBV) is intimately associated with pathogenesis. PTLD seen more younger children (more likely to be EBV seronegative), Caucasian race, association potent immunosuppression drugs. The clinical presentation typically involves multiple enlarged lymph nodes but varies based on localization lymphadenopathy. diagnosis primarily histopathological features. Treatment strategies include reduction immunosuppression, use anti-B cell antibodies, infusion EBV-specific cytotoxic T lymphocytes, chemotherapy. Many different have been tried prevent PTLD, ranging from serial viral load monitoring pre-emptive anti-viral prophylaxis. None treatment or prevention has subject randomized trials, so their relative efficacy still unknown. remains risk factor for graft loss, though re-transplants not, date, repeat PTLD.