Children (Jul 2021)
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
- 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
Affiliations
- Alastair Baker
- Paediatric Liver, Gastrointestinal and Nutrition Centre, School of Medicine, King’s College Hospital, King’s College London, Denmark Hill, London SE5 9RS, UK
- Esteban Frauca Remacha
- Servicio de Hepatología Pediátrica, Hospital Universitario La Paz, 28046 Madrid, Spain
- Juan Torres Canizales
- Lymphocyte Pathophysiology in Immunodeficiencies Group, La Paz Institute of Biomedical Research (IdiPAZ), Hospital Universitario La Paz and Center for Biomedical Network Research on Rare Diseases (CIBERER U767), 28046 Madrid, Spain
- Luz Yadira Bravo-Gallego
- Lymphocyte Pathophysiology in Immunodeficiencies Group, La Paz Institute of Biomedical Research (IdiPAZ), Hospital Universitario La Paz and Center for Biomedical Network Research on Rare Diseases (CIBERER U767), 28046 Madrid, Spain
- Emer Fitzpatrick
- Paediatric Liver, Gastrointestinal and Nutrition Centre, School of Medicine, King’s College Hospital, King’s College London, Denmark Hill, London SE5 9RS, UK
- Angel Alonso Melgar
- Servicio de Nefrología Pediátrica, Hospital Universitario La Paz, 28046 Madrid, Spain
- Gema Muñoz Bartolo
- Servicio de Hepatología Pediátrica, Hospital Universitario La Paz, 28046 Madrid, Spain
- Luis Garcia Guereta
- Servicio de Cardiología Pediátrica, Hospital Universitario La Paz, 28046 Madrid, Spain
- Esther Ramos Boluda
- Pediatric Gastroenterology Intestinal Rehabilitation Unit, University Hospital La Paz, 28046 Madrid, Spain
- Yasmina Mozo
- Pediatric Hemato-Oncology Department, Hospital Universitario La Paz, 28046 Madrid, Spain
- Dorota Broniszczak
- Department of Pediatric Surgery and Organ Transplantation, Children’s Memorial Health Institute, 04-730 Warsaw, Poland
- Wioletta Jarmużek
- Department of Nephrology and Kidney Transplantation, Children’s Memorial Health Institute, 04-730 Warsaw, Poland
- Piotr Kalicinski
- Department of Pediatric Surgery and Organ Transplantation, Children’s Memorial Health Institute, 04-730 Warsaw, Poland
- Britta Maecker-Kolhoff
- Department of Pediatric Hematology and Oncology, Hannover Medical School, 30625 Hannover, Germany
- Julia Carlens
- Clinic for Paediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, 30625 Hannover, Germany
- Ulrich Baumann
- Division of Paediatric Gastroenterology and Hepatology, Children’s Hospital, Hannover Medical School, 30625 Hannover, Germany
- Charlotte Roy
- Service de Pneumologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Université Paris, 75015 Paris, France
- Christophe Chardot
- Service de Chirurgie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Université Paris Descartes, 75015 Paris, France
- Elisa Benetti
- Pediatric Nephrology, Dialysis and Transplant Unit, Department of Women’s and Children’s Health, Azienda Ospedaliera di Padova, 35128 Padova, Italy
- Mara Cananzi
- Unit of Paediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child with Liver Transplantation, Department of Women’s and Children’s Health, Azienda Ospedaliera di Padova, 35128 Padova, Italy
- Elisabetta Calore
- Unit of Paediatric Onco-Haematology, Department of Women’s and Children’s Health, Azienda Ospedaliera di Padova, 35128 Padova, Italy
- Luca Dello Strologo
- Nephrology Unit, Bambino Gesù Children’s Research Hospital, IRCCS, 00165 Rome, Italy
- Manila Candusso
- Department of Hepatology and Gastroenterology, Bambino Gesù Children Hospital, 00165 Rome, Italy
- Maria Francelina Lopes
- Department of Paediatric Surgery, Centro Hospitalar e Universitário de Coimbra, and Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
- Manuel João Brito
- Department of Paediatric Oncology and Centro de Investigação e Formação Clínica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal
- Cristina Gonçalves
- Paediatric Liver Transplant Unit, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal
- Carmen Do Carmo
- Paediatric Nephrology Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal
- Xavier Stephenne
- Laboratoire d’Hépatologie Pédiatrique et Thérapie Cellulaire, Unité PEDI, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain (UCLouvain), 1200 Brussels, Belgium
- Lars Wennberg
- Department of Transplantation Surgery, Karolinska University Hospital, 171 76 Stockholm, Sweden
- Rosário Stone
- Unidade de Nefrologia e Transplantação Renal, Serviço de Pediatria Médica, Departamento de Pediatria, Hospital de Santa Maria, Centro Académico de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Jelena Rascon
- Centre for Paediatric Oncology and Haematology, Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania
- Caroline Lindemans
- Princess Maxima Center for Pediatric Oncology, Pediatric Blood and Marrow Transplantation Program, University Medical Center Utrecht, Utrecht University, 3584 CS Utrecht, The Netherlands
- Dominik Turkiewicz
- Department of Pediatrics, Skåne University Hospital, 222 42 Lund, Sweden
- Eugenia Giraldi
- Pediatric Oncology, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy
- Emanuele Nicastro
- Pediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy
- Lorenzo D’Antiga
- Pediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy
- Oanez Ackermann
- Pediatric Hepatology, National Centre for Biliary Atresia, Université París-Saclay, APHP, Hôpital Bicêtre, 94270 Le Kremlin-Bicêtre, France
- Paloma Jara Vega
- Servicio de Hepatología Pediátrica, Hospital Universitario La Paz, 28046 Madrid, Spain
- DOI
- https://doi.org/10.3390/children8080661
- Journal volume & issue
-
Vol. 8,
no. 8
p. 661
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.
Keywords
- PTLD
- post-transplant lymphoproliferative disorder
- pediatric
- solid organ transplantation
- immunosuppression
- Epstein–Barr virus
