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Epstein‐Barr virus–associated posttransplant lymphoproliferative disorder: Strategies for prevention and cure
Author(s) -
Nowalk Andrew J.,
Green Michael
Publication year - 2010
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.22141
Subject(s) - medicine , liver transplantation , lymphoproliferative disorders , virus , epstein–barr virus , immunology , virology , transplantation , lymphoma
KEY POINTS (1) No therapies for the treatment of Epstein‐Barr virus (EBV)–associated posttransplant lymphoproliferative disorder (PTLD) are based on data from randomized clinical trials. (2) Published clinical experience suggests that implementation of a systematic, stepwise approach to the treatment of EBV‐associated PTLD can result in improved outcomes. (3) Several new second‐line therapies, including monoclonal antibody therapies against B cell surface antigens and low‐dose chemotherapy for pediatric organ recipients with PTLD, have emerged over the last decade. (4) A variety of potential approaches to the prevention of EBV disease and PTLD, including chemoprophylaxis with antiviral therapy, immunoprophylaxis, and viral load monitoring to inform preemptive strategies, are currently under consideration. (5) Although many centers have endorsed the use of the antiviral agents acyclovir and ganciclovir for the prevention of EBV/PTLD, there are few data to support this practice. (6) At present, the use of serial monitoring of EBV viral loads as a stimulus for reducing immunosuppression appears to be the most promising strategy for the prevention of EBV disease and PTLD in liver transplant recipients. Liver Transpl 16:S54‐S59, 2010. © 2010 AASLD.