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

Abstract

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/leukemia. 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 days, and currently he has no symptoms of any human T-cell lymphoma virusassociated disease. Review of the medical literature demonstrates few reports on human T-cell lymphoma virusrelated complications after orthotopic liver transplantation; however, there 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.