The IPTA Nashville consensus conference on Post-Transplant lymphoproliferative disorders after solid organ transplantation in children: II-consensus guidelines for prevention

Michael Green, Division of Pediatric Infectious Diseases, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
James E. Squires, Division of Gastroenterology, Hepatology and Nutrition, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Richard E. Chinnock, Loma Linda University Children's Hospital, California, USA.
Patrizia Comoli, Cell Factory & Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico, San Matteo, Pavia, Italy.
Lara Danziger-Isakov, Division of Infectious Disease, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA.
Daniel E. Dulek, Division of Pediatric Infectious Diseases, Monroe Carell Jr. Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Carlos O. Esquivel, Stanford University School of Medicine, Stanford, California, USA.
Britta Höcker, Pediatrics I, University Children's Hospital, Heidelberg, Germany.
Arnaud G. L'Huillier, Pediatric Infectious Diseases Unit and Laboratory of Virology, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
George Vincent Mazariegos, Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh and Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Gary A. Visner, Division of Pulmonary Medicine, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, USA.
Catherine M. Bollard, Center for Cancer and Immunology Research, Children's National Hospital, The George Washington University, Washington, District of Columbia, USA.
Anne I. Dipchand, Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Judith A. Ferry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA.
Thomas G. Gross, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, Colorado, USA.
Robert Hayashi, Division of Pediatric Hematology/Oncology, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, Missouri, USA.
Britta Maecker-Kolhoff, Hannover Medical School, Pediatric Hematology and Oncology, Hannover, Germany.
Stephen Marks, Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Olivia M. Martinez, Department of Surgery and Program in Immunology, Stanford University School of Medicine, Stanford, California, USA.
Diana M. Metes, Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Marian G. Michaels, Division of Pediatric Infectious Diseases, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Jutta Preiksaitis, Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Françoise Smets, Pediatric Gastroenterology and Hepatology, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium.
Stephen H. Swerdlow, Division of Hematopathology, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Ralf U. Trappe, Department of Hematology and Oncology, DIAKO Ev. Diakonie-Krankenhaus Bremen, Bremen, Germany and Department of Internal Medicine II: Hematology and Oncology, University Medical Centre Schleswig-Holstein, Campus Kiel, Kiel, Germany.
James D. Wilkinson, Department of Pediatrics, Vanderbilt School of Medicine, Nashville, Tennessee, USA.
Upton Allen, Division of Infectious Diseases and the Transplant and Regenerative Medicine Center, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Steven A. Webber, Department of Pediatrics, Vanderbilt School of Medicine, Nashville, Tennessee, USA.
Vikas R. Dharnidharka, Department of Pediatrics, Division of Pediatric Nephrology, Hypertension & Pheresis, Washington University School of Medicine & St. Louis Children's Hospital, St. Louis, Missouri, USA.

Document Type

Journal Article

Publication Date

11-11-2022

Journal

Pediatric transplantation

DOI

10.1111/petr.14350

Abstract

The International Pediatric Transplant Association (IPTA) convened an expert consensus conference to assess current evidence and develop recommendations for various aspects of care relating to post-transplant lymphoproliferative disorder after solid organ transplantation in children. In this report from the Prevention Working Group, we reviewed the existing literature regarding immunoprophylaxis and chemoprophylaxis, and pre-emptive strategies. While the group made a strong recommendation for pre-emptive reduction of immunosuppression at the time of EBV DNAemia (low to moderate evidence), no recommendations for use could be made for any prophylactic strategy or alternate pre-emptive strategy, largely due to insufficient or conflicting evidence. Current gaps and future research priorities are highlighted.

Department

Pediatrics

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