Caillard S, Heibel F, Benaicha M, Moulin B
Service de néphrologie, Hôpitaux universitaires de Strasbourg.
Nephrologie. 1998;19(8):481-8.
Post-transplant lymphoproliferative disorders (PTLD) are recognized as a devastating complication of organ transplantation. Their occurrence appears to vary according to the transplanted organ and the type and the level of administered immunosuppressive therapy. In kidney transplants the incidence is estimated between 1 and 2%. PTLD represent a clinically and morphologically heterogeneous group of lymphoid proliferations. They have been closely associated with Epstein-Barr virus (EBV), and the spectrum of manifestations after transplantation range from an infectious mononucleosis-like syndrome to more serious polyclonal or monoclonal lymphoproliferation, the treatment of which is not well defined and, relying on immuno- and chemotherapy. Oncogenicity of EBV is not yet completely understood, but may implicate latent viral gene expression of EBNA or LMP as well as Th2 cytokines. Detection and monitoring of EBV induced lymphoid abnormalities are necessary to start early efficient antiviral treatment. Prophylactic antiviral therapy has to be considered.
移植后淋巴细胞增生性疾病（PTLD）被认为是器官移植的一种毁灭性并发症。其发生率似乎因移植器官、所给予免疫抑制治疗的类型和程度而异。在肾移植中，发生率估计在1%至2%之间。PTLD代表一组临床和形态学上异质性的淋巴样增生。它们与爱泼斯坦-巴尔病毒（EBV）密切相关，移植后的表现范围从传染性单核细胞增多症样综合征到更严重的多克隆或单克隆淋巴样增生，其治疗方法尚不明确，依赖于免疫治疗和化疗。EBV的致癌性尚未完全了解，但可能涉及EBNA或LMP的潜伏病毒基因表达以及Th2细胞因子。检测和监测EBV诱导的淋巴样异常对于尽早开始有效的抗病毒治疗是必要的。必须考虑预防性抗病毒治疗。
