Epstein-Barr virus-associated post-transplant lympho-proliferative disease of donor origin in liver transplant recipients.
OBJECTIVE
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.
Strazzabosco
M
M
Institute of Internal Medicine, University of Padova and Azienda Ospedaliera di Padova, Padua, Italy.
Corneo
B
B
Iemmolo
R M
RM
Menin
C
C
Gerunda
G
G
Bonaldi
L
L
Merenda
R
R
Neri
D
D
Poletti
A
A
Montagna
M
M
Del Mistro
A
A
Faccioli
A M
AM
D'Andrea
E
E
D001402:B-Lymphocytes / Q000473:pathology; D002460:Cell Line; D006566:Herpesviridae Infections / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D004854:Herpesvirus 4, Human; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000209:etiology* / Q000235:genetics / Q000821:virology*; D008297:Male; D018895:Microsatellite Repeats; D008875:Middle Aged; D014019:Tissue Donors; D014057:Tomography, X-Ray Computed; D014412:Tumor Virus Infections / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology