移植技术与研究

Human T-Cell Lymphoma Virus-Positive Allograft Used For Effective Orthotopic Liver Transplantation: A Case Report and Review of the Literature

Abstract

TR Harring, NT Nguyen, JA Goss and CA O�?�??Mahony

Introduction: The human T cell lymphoma virus was screened for previously in organ donors secondary to concern for progressive disease in an immunocompromised host. However, due to the low prevalence of the virus, a shortage of suitable allografts, and the lack of a time effective test, this practice has been abandoned in the United States. The human T cell lymphoma virus type I may cause progression to several diseases, including human T cell lymphoma virus associated myelopathy, and adult T cell lymphoma/l eukemia. Moreover, there is an overall lack of data relating to the safety profile in the medical literature with use of human T cell lymphoma virus positive allografts.

Aim: To determine the safety of human T cell lymphoma virus positive allografts in orthotopic liver transplantation.

Materials and Methods: Our database was queried for recipients of known human T cell lymphoma virus positive allografts at time of transplantation. We present one patient case report followed by a review of the medical literature.

Results: The patient was transplanted secondary to cirrhosis due to alcohol and hepatitis C virus infection with hepatocellular carcinoma. When a suitable allograft became available, the patient was advised that it was human T cell lymphoma virus type I positive. The risks and benefits were discussed thoroughly with the patient and he elected to proceed with the operation. His operation and post operative course were unremarkable. He continues to do well during on follow up of over 777 day s, and currently he has no symptoms of any human T cell lymphoma virus associated disease. Review of the medical literature demonstrates few reports on human T cell lymphoma virus related complications after orthotopic liver transplantation; however, the re are theories that immunosuppresion may cause progressive disease in these patients.

Conclusions: Human T cell lymphoma virus type I positive donors can be life saving sources of allografts. Our center supports the use of these allografts in patients that otherwise continue to be on the waiting list.