LYMPHOPROLIFERATIVE DISORDER AFTER LIVER-TRANSPLANTATION

Lymphoproliferative disorder (LPD) is a well recognized complication o f solid organ transplantation. It is associated with Epstein-Barr viru s (EBV) infection and is often a fatal complication of immunosuppressi on. We report a 2.5-year-old boy who developed LPD presenting as small bowel lymphoma after liver transplantation. The patient had intermitt ent fever after transplantation and reactivation of latent EBV infecti on was documented by pre- and posttransplant serologic tests. About 5 months after his liver transplantation, the patient had sudden onset o f abdominal pain and emergency laparotomy was performed for peritoniti s. He proved to have multiple small bowel perforations caused by B cel l lymphoma and died of multiple organ failure 9 days after operation, despite aggressive treatment and stopping immunosuppressive agents. We conclude that prevention of overimmunosuppression in pediatric recipi ents after liver transplantation and early detection and treatment of LPD are important to decrease this often-fatal complication.