DISSEMINATED KAPOSIS-SARCOMA AFTER HEART-TRANSPLANTATION - ASSOCIATION WITH KAPOSIS SARCOMA-ASSOCIATED HERPESVIRUS

Background: Kaposi's sarcoma is an endothelial tumor rarely diagnosed after heart transplantation. We report on a patient originally from Af rica in whom Kaposi's sarcoma developed in association with Kaposi's s arcoma-associated herpesvirus. Methods: A man from Ghana had constitut ional symptoms associated with multiple pulmonary nodules that develop ed 3 months after heart transplantation. Kaposi's sarcoma was diagnose d by thorascopic biopsy. Treatment consisted of reducing immunosuppres sion therapy and adding famciclovir treatment. Symptoms resolved withi n 1 month after treatment, and no disease progression was observed for 5 months. The patient died suddenly 8 months after heart transplantat ion; autopsy revealed occlusion of the left anterior descending corona ry artery and grade 3A rejection. Extensive Kaposi's sarcoma was obser ved in the lungs and gastrointestinal tract at autopsy. Results: Patho logic analysis of the tumor demonstrated features consistent with Kapo si's sarcoma. Polymerase chain reaction and in situ hybridization demo nstrated the presence of Kaposi's sarcoma-associated herpesvirus. Conc lusion: Kaposi's sarcoma rarely is diagnosed after transplantation. Pa tients infected with Kaposi's sarcoma-associated herpesvirus may be at increased risk, Screening for Kaposi's sarcoma-associated herpesvirus may be indicated in patients at risk. The role of antiviral medicatio ns and immunization in the treatment and prevention of the disorder is unknown.