Nanmoku Koji, Shinzato Takahiro, Kubo Taro, Shimizu Toshihiro, Yagisawa Takashi
Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Shimotsuke, Japan.
Transpl Infect Dis. 2019 Aug;21(4):e13116. doi: 10.1111/tid.13116. Epub 2019 May 30.
Post-transplant lymphoproliferative disorder (PTLD) is a fatal complication of transplantation. There is no clear consensus on the treatment of PTLD. In most cases, the pathogenetic mechanism of PTLD involves the Epstein-Barr virus (EBV). We report the case of an elderly kidney transplant recipient who developed EBV-positive monomorphic T-cell PTLD 14 years after transplantation. Conversion from conventional immunosuppressants to everolimus induced complete remission of PTLD accompanied by a decrease in blood EBV-DNA level without chemotherapy.
移植后淋巴细胞增生性疾病（PTLD）是移植的一种致命并发症。关于PTLD的治疗尚无明确共识。在大多数情况下，PTLD的发病机制涉及爱泼斯坦-巴尔病毒（EBV）。我们报告了一例老年肾移植受者的病例，该患者在移植后14年发生了EBV阳性单形性T细胞PTLD。从传统免疫抑制剂转换为依维莫司可诱导PTLD完全缓解，同时血液EBV-DNA水平降低，且无需化疗。
