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儿童实体器官移植后移植后淋巴增殖性疾病的IPTA纳什维尔共识会议:II-预防共识指南

The IPTA Nashville consensus conference on Post-Transplant lymphoproliferative disorders after solid organ transplantation in children: II-consensus guidelines for prevention.

作者信息

Green Michael, Squires James E, Chinnock Richard E, Comoli Patrizia, Danziger-Isakov Lara, Dulek Daniel E, Esquivel Carlos O, Höcker Britta, L'Huillier Arnaud G, Mazariegos George Vincent, Visner Gary A, Bollard Catherine M, Dipchand Anne I, Ferry Judith A, Gross Thomas G, Hayashi Robert, Maecker-Kolhoff Britta, Marks Stephen, Martinez Olivia M, Metes Diana M, Michaels Marian G, Preiksaitis Jutta, Smets Françoise, Swerdlow Stephen H, Trappe Ralf U, Wilkinson James D, Allen Upton, Webber Steven A, Dharnidharka Vikas R

机构信息

Division of Pediatric Infectious Diseases, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Division of Gastroenterology, Hepatology and Nutrition, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

出版信息

Pediatr Transplant. 2024 Feb;28(1):e14350. doi: 10.1111/petr.14350. Epub 2022 Nov 11.

Abstract

The International Pediatric Transplant Association (IPTA) convened an expert consensus conference to assess current evidence and develop recommendations for various aspects of care relating to post-transplant lymphoproliferative disorder after solid organ transplantation in children. In this report from the Prevention Working Group, we reviewed the existing literature regarding immunoprophylaxis and chemoprophylaxis, and pre-emptive strategies. While the group made a strong recommendation for pre-emptive reduction of immunosuppression at the time of EBV DNAemia (low to moderate evidence), no recommendations for use could be made for any prophylactic strategy or alternate pre-emptive strategy, largely due to insufficient or conflicting evidence. Current gaps and future research priorities are highlighted.

摘要

国际儿科移植协会(IPTA)召开了一次专家共识会议,以评估现有证据,并就儿童实体器官移植后移植后淋巴细胞增生性疾病相关护理的各个方面制定建议。在预防工作组的这份报告中,我们回顾了有关免疫预防、化学预防和抢先策略的现有文献。虽然该小组强烈建议在EBV血症时抢先降低免疫抑制(证据等级为低到中等),但由于证据不足或相互矛盾,无法对任何预防策略或替代抢先策略提出使用建议。文中突出了当前的差距和未来的研究重点。

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