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Current Practices on Diagnosis, Prevention and Treatment of Post-Transplant Lymphoproliferative Disorder in Pediatric Patients after Solid Organ Transplantation: Results of ERN TransplantChild Healthcare Working Group Survey

Authors :
Alastair Baker
Esteban Frauca Remacha
Juan Torres Canizales
Luz Yadira Bravo-Gallego
Emer Fitzpatrick
Angel Alonso Melgar
Gema Muñoz Bartolo
Luis Garcia Guereta
Esther Ramos Boluda
Yasmina Mozo
Dorota Broniszczak
Wioletta Jarmużek
Piotr Kalicinski
Britta Maecker-Kolhoff
Julia Carlens
Ulrich Baumann
Charlotte Roy
Christophe Chardot
Elisa Benetti
Mara Cananzi
Elisabetta Calore
Luca Dello Strologo
Manila Candusso
Maria Francelina Lopes
Manuel João Brito
Cristina Gonçalves
Carmen Do Carmo
Xavier Stephenne
Lars Wennberg
Rosário Stone
Jelena Rascon
Caroline Lindemans
Dominik Turkiewicz
Eugenia Giraldi
Emanuele Nicastro
Lorenzo D’Antiga
Oanez Ackermann
Paloma Jara Vega
Source :
Children, Vol 8, Iss 8, p 661 (2021)
Publication Year :
2021
Publisher :
MDPI AG, 2021.

Abstract

(1) Background: Post-transplant lymphoproliferative disease (PTLD) is a significant complication of solid organ transplantation (SOT). However, there is lack of consensus in PTLD management. Our aim was to establish a present benchmark for comparison between international centers and between various organ transplant systems and modalities; (2) Methods: A cross-sectional questionnaire of relevant PTLD practices in pediatric transplantation was sent to multidisciplinary teams from 17 European center members of ERN TransplantChild to evaluate the centers’ approach strategies for diagnosis and treatment and how current practices impact a cross-sectional series of PTLD cases; (3) Results: A total of 34 SOT programs from 13 European centers participated. The decision to start preemptive treatment and its guidance was based on both EBV viremia monitoring plus additional laboratory methods and clinical assessment (61%). Among treatment modalities the most common initial practice at diagnosis was to reduce the immunosuppression (61%). A total of 126 PTLD cases were reported during the period 2012–2016. According to their histopathological classification, monomorphic lesions were the most frequent (46%). Graft rejection after PTLD remission was 33%. Of the total cases diagnosed with PTLD, 88% survived; (4) Conclusions: There is still no consensus on prevention and treatment of PTLD, which implies the need to generate evidence. This might successively allow the development of clinical guidelines.

Details

Language :
English
ISSN :
22279067
Volume :
8
Issue :
8
Database :
Directory of Open Access Journals
Journal :
Children
Publication Type :
Academic Journal
Accession number :
edsdoj.4cb0f49cb584054a82941ab9f84d7ba
Document Type :
article
Full Text :
https://doi.org/10.3390/children8080661