title: Epstein-Barr virus-associated post-transplant lympho-proliferative disease of donor origin in liver transplant recipients.
abstract: 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.
authors.affiliation: Institute of Internal Medicine, University of Padova and Azienda Ospedaliera di Padova, Padua, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Strazzabosco
authors.forename: B
authors.initials: B
authors.lastname: Corneo
authors.forename: R M
authors.initials: RM
authors.lastname: Iemmolo
authors.forename: C
authors.initials: C
authors.lastname: Menin
authors.forename: G
authors.initials: G
authors.lastname: Gerunda
authors.forename: L
authors.initials: L
authors.lastname: Bonaldi
authors.forename: R
authors.initials: R
authors.lastname: Merenda
authors.forename: D
authors.initials: D
authors.lastname: Neri
authors.forename: A
authors.initials: A
authors.lastname: Poletti
authors.forename: M
authors.initials: M
authors.lastname: Montagna
authors.forename: A
authors.initials: A
authors.lastname: Del Mistro
authors.forename: A M
authors.initials: AM
authors.lastname: Faccioli
authors.forename: E
authors.initials: E
authors.lastname: D'Andrea
mesh_terms: 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