Post-transplantation lymphoproliferative disorders: advances in diagnosis,prevention and management in children

With improving operative and postoperative survival after pediatric thoraci c transplantation, attention has appropriately begun to focus on complicati ons of long-term immunosuppression. One important complication is post-tran splantation lymphoproliferative disorders. Much has been learnt about this spectrum of disorders over the last 15 years, including the pivotal role of primary Epstein-Barr virus infection in the etiology of most cases. Despit e these advances, nomenclature remains confusing for the clinician, predict ion of outcome is imprecise and treatment strategies are poorly defined. In deed, no treatments have been subjected to comparative prospective clinical trials. Only recently has attention focussed on strategies for prevention. This article will review the current state of knowledge of post-transplant ation lymphoproliferative disorders, with emphasis on recent advances in di agnosis, prevention and management. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.