https://pubmed.ncbi.nlm.nih.gov/34438552/ Liver Transplant

Children (Basel). 2021 Jul 29;8(8):661.
doi: 10.3390/children8080661.

Current Practices on Diagnosis, Prevention and Treatment of Post-Transplant Lymphoproliferative Disorder in Pediatric Patients after Solid Organ Transplantation: Results of ERN TransplantChild Healthcare Working Group Survey

Alastair Baker 1, Esteban Frauca Remacha 2, Juan Torres Canizales 3, Luz Yadira Bravo-Gallego 3, Emer Fitzpatrick 1, Angel Alonso Melgar 4, Gema Muñoz Bartolo 2, Luis Garcia Guereta 5, Esther Ramos Boluda 6, Yasmina Mozo 7, Dorota Broniszczak 8, Wioletta Jarmużek 9, Piotr Kalicinski 8, Britta Maecker-Kolhoff 10, Julia Carlens 11, Ulrich Baumann 12, Charlotte Roy 13, Christophe Chardot 14, Elisa Benetti 15, Mara Cananzi 16, Elisabetta Calore 17, Luca Dello Strologo 18, Manila Candusso 19, Maria Francelina Lopes 20, Manuel João Brito 21, Cristina Gonçalves 22, Carmen Do Carmo 23, Xavier Stephenne 24, Lars Wennberg 25, Rosário Stone 26, Jelena Rascon 27, Caroline Lindemans 28, Dominik Turkiewicz 29, Eugenia Giraldi 30, Emanuele Nicastro 31, Lorenzo D'Antiga 31, Oanez Ackermann 32, Paloma Jara Vega 2 33

Abstract
(1) Background: Post-transplant lymphoproliferative disease (PTLD) is a significant complication of solid organ transplantation (SOT). However, there is lack of consensus in PTLD management. Our aim was to establish a present benchmark for comparison between international centers and between various organ transplant systems and modalities; (2) Methods: A cross-sectional questionnaire of relevant PTLD practices in pediatric transplantation was sent to multidisciplinary teams from 17 European center members of ERN TransplantChild to evaluate the centers' approach strategies for diagnosis and treatment and how current practices impact a cross-sectional series of PTLD cases; (3) Results: A total of 34 SOT programs from 13 European centers participated. The decision to start preemptive treatment and its guidance was based on both EBV viremia monitoring plus additional laboratory methods and clinical assessment (61%). Among treatment modalities the most common initial practice at diagnosis was to reduce the immunosuppression (61%). A total of 126 PTLD cases were reported during the period 2012-2016. According to their histopathological classification, monomorphic lesions were the most frequent (46%). Graft rejection after PTLD remission was 33%. Of the total cases diagnosed with PTLD, 88% survived; (4) Conclusions: There is still no consensus on prevention and treatment of PTLD, which implies the need to generate evidence. This might successively allow the development of clinical guidelines.