title: Operative endoscopy for treatment of native rectal post-transplantation lymphoproliferative disease after adult small bowel transplantation: a case report.
abstract: Post-transplantation lymphoproliferative disease (PTLD) of the gastrointestinal (GI) tract is often recognized in transplant recipients. Small bowel recipients are prone to develop GI disease due to the higher incidence of Epstein-Barr Virus (EBV) infection and enteritis as a consequence of heavy immunosuppressive regimens. So far treatment has been based on anti-CD20 therapy (Rituximab), modulation of immunosuppression, antiviral therapy (Gancyclovir), and surgery (up to allograft enterectomy if necessary), whereas endoscopy is usually used to perform the diagnosis via biopsy. We report a case of an adult small bowel recipient, who underwent transplantation due to Gardner's Syndrome 6 years earlier and was EBV positive. A native rectal PTLD was treated using opertive endoscopy combined with antiviral therapy using 4 courses of Rituximab for positive pelvic lymph nodes in addition to reduced immunosuppression. Two years after treatment the recipient is alive and disease-free with a functional graft.
authors.affiliation: Liver and Multiorgan Transplant Unit S.Orsola University Hospital, Bologna, Italy. Electronic address: augustola@yahoo.com.
authors.forename: A
authors.initials: A
authors.lastname: Lauro
authors.forename: M
authors.initials: M
authors.lastname: Di Simone
authors.forename: C
authors.initials: C
authors.lastname: Zanfi
authors.forename: L
authors.initials: L
authors.lastname: Pironi
authors.forename: A
authors.initials: A
authors.lastname: D'Errico
authors.forename: A D
authors.initials: AD
authors.lastname: Pinna
mesh_terms: D000328:Adult; D006801:Humans; D007421:Intestine, Small / Q000637:transplantation*; D008232:Lymphoproliferative Disorders / Q000150:complications*; D008297:Male