title: Delayed seroconversion and rapid onset of lymphoproliferative disease after transmission of human T-cell lymphotropic virus type 1 from a multiorgan donor.
abstract: BACKGROUND
  Human T-cell lymphotropic virus type 1 (HTLV-1) screening of blood and organ donors is not mandatory in Germany because of its low prevalence (about 7/100 000). An HTLV-1 transmission event caused by a multiple organ donor was investigated. Validity of diagnostic procedures and HTLV-1 disease association in immunosuppressed organ recipients were analyzed.
  
  
  METHODS
  Two screening immunoassays and an immunoblot (confirmatory assay) were used for detection of HLTV-1/2 antibodies. Proviral DNA was quantified in blood and biopsies of organ recipients by HTLV-1 real-time polymerase chain reaction (PCR).
  
  
  RESULTS
  Proviral HTLV-1-DNA was detected in all blood samples of 3 organ recipients (1-100 copies/10(2) cells), but seroconversion was delayed for up to 2 years in screening assays and >6 years in the confirmatory assay. In 2 of 3 organ recipients, a cutaneous T-cell lymphoma was diagnosed 2 and 3 years after infection, respectively. Proviral HTLV-1 DNA concentration was almost 100 copies/10(2) cells in cutaneous lymphoma biopsies whereas in biopsies of other tissues ≤3.0 copies/10(2) cells were found. The third organ recipient did not suffer from lymphoma, but detailed clinical data on this patient were not available to us.
  
  
  CONCLUSIONS
  Biopsy results support an etiological role for HTLV-1 in these cases of primary cutaneous T-cell lymphoma after solid organ transplant. HTLV-1-associated lymphoma can arise quickly in immunocompromised transplant recipients. The diagnosis of potentially HTLV-1-associated disease in organ recipients may require PCR because of delayed seroconversion.
authors: Institute of Virology, Hannover Medical School.
authors: Ilona
authors: I
authors: Glowacka
authors: Klaus
authors: K
authors: Korn
authors: Sebastian A
authors: SA
authors: Potthoff
authors: Ulrich
authors: U
authors: Lehmann
authors: Hans H
authors: HH
authors: Kreipe
authors: Katrin
authors: K
authors: Ivens
authors: Hannelore
authors: H
authors: Barg-Hock
authors: Thomas F
authors: TF
authors: Schulz
authors: Albert
authors: A
authors: Heim
mesh_terms: D000914:Antibodies, Viral / Q000097:blood*; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015490:HTLV-I Infections / Q000097:blood / Q000821:virology*; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification*; D006801:Humans; D008223:Lymphoma / Q000097:blood / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000737:chemistry / Q000276:immunology; D014019:Tissue Donors; D014180:Transplantation / Q000009:adverse effects*
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral
keywords: HTLV-1; SOT; cutaneous lymphoma; transmission; transplantation