title: Symptomatic pulmonary allograft Kaposi's sarcoma in two lung transplant recipients.
abstract: Kaposi's sarcoma (KS) is associated with solid-organ transplantation, but is extremely rare after lung transplantation. In this report, we describe two unique cases of lung transplant recipients who developed KS in the lung allograft and were treated with sirolimus and liposomal doxorubicin. One patient survived 12 months after the diagnosis of KS; the other survived 3 months after diagnosis and was found to have concomitant EBV-negative, HHV-8-positive B-cell lymphoma. We demonstrate a partial response of pulmonary KS to reduced immunosuppression and the initiation of sirolimus in one patient, as well as an association between increasing HHV-8 viremia and progression of pulmonary KS. Our report highlights the importance of secondary malignancies in patients with transplant-related KS and supports the association between HHV-8 infection and EBV-negative PTLD.
authors.affiliation: Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, NC, USA. shailaja_v@hotmail.com
authors.forename: S J
authors.initials: SJ
authors.lastname: Sathy
authors.forename: T
authors.initials: T
authors.lastname: Martinu
authors.forename: K
authors.initials: K
authors.lastname: Youens
authors.forename: C M
authors.initials: CM
authors.lastname: Lawrence
authors.forename: D N
authors.initials: DN
authors.lastname: Howell
authors.forename: S M
authors.initials: SM
authors.lastname: Palmer
authors.forename: M P
authors.initials: MP
authors.lastname: Steele
mesh_terms: D000328:Adult; D004317:Doxorubicin / Q000627:therapeutic use; D017809:Fatal Outcome; D019288:Herpesvirus 8, Human / Q000276:immunology; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012514:Sarcoma, Kaposi / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*; D020123:Sirolimus / Q000627:therapeutic use; D014019:Tissue Donors; D014184:Transplantation, Homologous; D019737:Transplants / Q000821:virology*; D019562:Viral Load
chemical_list: D007166:Immunosuppressive Agents; D004317:Doxorubicin; D020123:Sirolimus