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Pediatric post-transplant hepatic kaposi sarcoma due to donor-derived human herpesvirus 8.

Identifieur interne : 000262 ( Main/Exploration ); précédent : 000261; suivant : 000263

Pediatric post-transplant hepatic kaposi sarcoma due to donor-derived human herpesvirus 8.

Auteurs : Karen E. Ocwieja [États-Unis] ; Sara O. Vargas [États-Unis] ; Scott A. Elisofon [États-Unis] ; David S. Shulman [États-Unis] ; Christine K. Lee [États-Unis] ; Rima Fawaz [États-Unis] ; Natalie Collins [États-Unis] ; Khashayar Vakili [États-Unis] ; Tanvi S. Sharma [États-Unis]

Source :

RBID : pubmed:30843320

Descripteurs français

English descriptors

Abstract

In areas of the world where human herpesvirus 8 (HHV-8) is endemic, Kaposi sarcoma (KS) is a common SOT-associated cancer. In the United States, where the virus is not prevalent, PTKS is rare, and there is little literature on pediatric PTKS. We present a North American female who underwent deceased donor, left lateral segment liver transplant for biliary atresia at age 11 months. The donor was a male with no known history of KS, originally from an HHV-8-endemic country. Three months after transplantation, the patient developed liver nodules and portal vein thrombosis. Analysis of needle biopsy established the diagnosis of KS and confirmed that the transformed cells were donor-derived. HHV-8 viremia was detected, and ganciclovir dosing (which had been started prophylactically) was increased. Immunosuppression was changed from tacrolimus to sirolimus. After further disease progression, 8 cycles of paclitaxel were administered. Under this treatment, her nodules regressed, HHV-8 viremia resolved, and she had marked clinic improvement. Notably, the adult recipient of the right liver lobe from the same donor also developed PTKS. This is one of few pediatric PTKS cases described in the literature. It contributes to the mechanistic understanding of PTKS development, illustrating the risk posed by donors from HHV-8-endemic countries, as well as the potential for strong PTKS correlation between multiple recipients of organs from a single shared donor.

DOI: 10.1111/petr.13384
PubMed: 30843320


Affiliations:


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Le document en format XML

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<term>Biliary Atresia (complications)</term>
<term>Biliary Atresia (surgery)</term>
<term>Biopsy, Needle (MeSH)</term>
<term>Disease Progression (MeSH)</term>
<term>Female (MeSH)</term>
<term>Ganciclovir (therapeutic use)</term>
<term>Herpesvirus 8, Human (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Immunosuppression (MeSH)</term>
<term>Infant (MeSH)</term>
<term>Liver (diagnostic imaging)</term>
<term>Liver Transplantation (adverse effects)</term>
<term>Magnetic Resonance Imaging (MeSH)</term>
<term>Male (MeSH)</term>
<term>Paclitaxel (therapeutic use)</term>
<term>Postoperative Complications (diagnosis)</term>
<term>Sarcoma, Kaposi (virology)</term>
<term>Tissue Donors (MeSH)</term>
</keywords>
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<term>Atrésie des voies biliaires (chirurgie)</term>
<term>Atrésie des voies biliaires (complications)</term>
<term>Complications postopératoires (diagnostic)</term>
<term>Donneurs de tissus (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Foie (imagerie diagnostique)</term>
<term>Ganciclovir (usage thérapeutique)</term>
<term>Herpèsvirus humain de type 8 (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Imagerie par résonance magnétique (MeSH)</term>
<term>Immunosuppression thérapeutique (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Nourrisson (MeSH)</term>
<term>Paclitaxel (usage thérapeutique)</term>
<term>Ponction-biopsie à l'aiguille (MeSH)</term>
<term>Sarcome de Kaposi (virologie)</term>
<term>Transplantation hépatique (effets indésirables)</term>
<term>Évolution de la maladie (MeSH)</term>
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<term>Ganciclovir</term>
<term>Paclitaxel</term>
</keywords>
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<term>Atrésie des voies biliaires</term>
<term>Transplantation hépatique</term>
</keywords>
<keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr">
<term>Foie</term>
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<term>Biliary Atresia</term>
</keywords>
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<term>Ganciclovir</term>
<term>Paclitaxel</term>
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<term>Herpesvirus 8, Human</term>
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<term>Femelle</term>
<term>Herpèsvirus humain de type 8</term>
<term>Humains</term>
<term>Imagerie par résonance magnétique</term>
<term>Immunosuppression thérapeutique</term>
<term>Mâle</term>
<term>Nourrisson</term>
<term>Ponction-biopsie à l'aiguille</term>
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<div type="abstract" xml:lang="en">In areas of the world where human herpesvirus 8 (HHV-8) is endemic, Kaposi sarcoma (KS) is a common SOT-associated cancer. In the United States, where the virus is not prevalent, PTKS is rare, and there is little literature on pediatric PTKS. We present a North American female who underwent deceased donor, left lateral segment liver transplant for biliary atresia at age 11 months. The donor was a male with no known history of KS, originally from an HHV-8-endemic country. Three months after transplantation, the patient developed liver nodules and portal vein thrombosis. Analysis of needle biopsy established the diagnosis of KS and confirmed that the transformed cells were donor-derived. HHV-8 viremia was detected, and ganciclovir dosing (which had been started prophylactically) was increased. Immunosuppression was changed from tacrolimus to sirolimus. After further disease progression, 8 cycles of paclitaxel were administered. Under this treatment, her nodules regressed, HHV-8 viremia resolved, and she had marked clinic improvement. Notably, the adult recipient of the right liver lobe from the same donor also developed PTKS. This is one of few pediatric PTKS cases described in the literature. It contributes to the mechanistic understanding of PTKS development, illustrating the risk posed by donors from HHV-8-endemic countries, as well as the potential for strong PTKS correlation between multiple recipients of organs from a single shared donor.</div>
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<name sortKey="Ocwieja, Karen E" sort="Ocwieja, Karen E" uniqKey="Ocwieja K" first="Karen E" last="Ocwieja">Karen E. Ocwieja</name>
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<name sortKey="Elisofon, Scott A" sort="Elisofon, Scott A" uniqKey="Elisofon S" first="Scott A" last="Elisofon">Scott A. Elisofon</name>
<name sortKey="Fawaz, Rima" sort="Fawaz, Rima" uniqKey="Fawaz R" first="Rima" last="Fawaz">Rima Fawaz</name>
<name sortKey="Lee, Christine K" sort="Lee, Christine K" uniqKey="Lee C" first="Christine K" last="Lee">Christine K. Lee</name>
<name sortKey="Sharma, Tanvi S" sort="Sharma, Tanvi S" uniqKey="Sharma T" first="Tanvi S" last="Sharma">Tanvi S. Sharma</name>
<name sortKey="Shulman, David S" sort="Shulman, David S" uniqKey="Shulman D" first="David S" last="Shulman">David S. Shulman</name>
<name sortKey="Vakili, Khashayar" sort="Vakili, Khashayar" uniqKey="Vakili K" first="Khashayar" last="Vakili">Khashayar Vakili</name>
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</record>

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