Post-transplant Epstein–Barr Virus-Related Lymphoproliferative Disorder: A Case Report and Review of Literature

Abstract

AbstractPost transplant lympho-proliferative disorders (PTLD) are a serious complications of solid organ transplantation. Solid organ recipients have an increased risk of cancers related to immunosuppression and the Epstein-Barr virus (EBV)-in particular lymphomas and majority of PTLD are of B-cell origin. The occurrence of PTLD in solid organ recipients can have varied clinical presentation and histopathological features. Although lymphoproliferative disorders were initially reported to be rare complication of transplantation, observations in past decade shown that they are common and are associated with poor outcomes. We report the case of a patient with deceased donor liver transplantation for Budd-chiari syndrome, who presented, four years after liver transplantation, with an EBV-associated Burkitt lymphoma with gastrointestinal and extensive skeletal metastasis recovered completely after adjustment of immunosuppressive treatment and chemo-immunotherapy. Our suggestion is that patients with the risk factors like T-cell depleting agents or increasing immunosuppressive therapy must be closely monitored with quantitative EBV PCR. Improvements in immunosuppressive strategies for transplantation and advances in treatment resulted in improved outcomes and long term survival for patients with PTLD.