[Intrathoracic occurrence of post-transplantation lymphoproliferation].
In the submitted case-history the authors wished to draw attention to serious complications after transplantation. Posttransplantation lymphoproliferation (PTLP) is a rare complication of organ transplantation, its incidence amounts to some 2% of organ recipients, in combined heart-lung transplantations the incidence is as high as 10%. The prerequisite of lymphproliferations is infection with the Epstein-Barr virus. The virus causes transformation of B lymphocytes and subsequent lymphoproliferation. Immunosuppressive preparations, due to their effect on Tlymphocytes promote this transformation. The decisive imaging method in tumoriform occurrence is high resolution computed tomography. Based on CT examination surgical biopsy is performed with subsequent in situ hybridization which confirms unequivocally the diagnosis of posttransplantation lymphoproliferation. Only on the basis of results of in situ hybridization treatment may be started which involves restriction or discontinuation of immunosuppressive treatment and administration of antiviral preparations. Frequently this treatment fails and must be discontinued on account of a rejection reaction of the organism. The prognosis in untreated forms is adverse.
Jirava
D
D
Chirurgická klinika FNKV, 3. LF UK, Praha.
Fuchsová
M
M
Fanta
J
J
Dutka
J
J
Jirásek
A
A
D000328:Adult; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000209:etiology* / Q000821:virology; D008297:Male; D013896:Thoracic Diseases / Q000175:diagnosis / Q000209:etiology*