|Tipo di tesi||Tesi di laurea specialistica|
|Titolo||Riattivazione di EBV nel periodo successivo del trapianto di rene: Fattori di rischio e risposte immunitarie specifiche.|
|Titolo in inglese||EBV reactivation in the post kidney transplant period: risk factors and specific immune-responses.|
|Struttura||Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze|
|Corso di studi||MEDICINA E CHIRURGIA|
|Data inizio appello||2015-07-15|
|Disponibilità||Accessibile via web (tutti i file della tesi sono accessibili)|
Background The post-transplant lymphoproliferative disorder (PTLD) are one of the most destructive complications of solid organ transplantation (1). The genome of the Epstein-Barr virus is found in the majority (> 90%) of PTLD which develop within one year after transplant . These lymphoproliferative disorders may have symptoms very different, going from mononucleosis syndrome without complications to the actual tumor that may have lymph node or extranodal location, out of the graft or be disseminated (2,3). Injuries can be localized and progress slowly or present with a fulminant multisystem syndrome like sepsis. It is well known that EBV plays an important role in the development of PTLD. The pathogenesis of these disorders is complex and related to the ability of EBV to transform and to immortalize lymphocytes B. Despite the transformation of B cells and PTLD are results of latent EBV infection, EBV lytic infection seems to be extremely important during EBV primary infection for the development of the response of cytotoxic T lymphocytes. In a patient who had a primary infection with EBV in the immediate post-transplant period, the delay in the development of a specific immune response would facilitate the infection of a larger number of naive B lymphocytes, cells of memory latency and viral reactivation (4,5). The high viral load resulting from these processes cause a massive infection of T lymphocytes and also of other cells normally not infected by EBV as T lymphocytes, NK lymphocytes, memory B cells, laying the foundations for secondary events that can lead to the formation of neoplasms (6). Although the role of EBV in PTLD is unclear, recent data out themselves the hypothesis that after an initial lymphoproliferation led by EBV, other cell mutations, that can carry an uncontrolled cell proliferation, develop. (7) Objectives Primary objective: evaluation incidence of EBV reactivation in the post-kidney transplant Secondary objectives: evaluation independent risk factors in renal transplant patients for reactivation of EBV in the post-transplant; probability rating after reactivation of EBV to develop effectively a PTLD. Cost-benefit analysis of such a practice. Methods It will be conducted a retrospective observational study at the University Hospital of the Policlinico of Modena.