A Scheduled Program of Molecular Screening for Epstein-Barr Virus Decreases the Incidence of Post-transplantation Lymphoproliferative Disease in Pediatric Liver Transplantation

Abstract This is a cohort, retrospective, comparative study of all liver transplant recipients from a single center, from May 1998 to July 2015. Patients were divided into two groups according to the type of Epstein-Barr viral load monitoring. For group I (1998–2007), polymerase chain reaction (PCR)...

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Bibliographic Details
Published in:Transplantation proceedings 2016-03, Vol.48 (2), p.654-657
Main Authors: Soriano-López, D.P, Alcántar-Fierros, J.M, Hernández-Plata, J.A, González-Jorge, A.L, Velázquez-Ramos, S, Flores-Hernández, M.A, Fuentes, V, Castañeda, P, Nieto, J, Sánchez, J.L, López, B, Valencia-Mayoral, P, Varela-Fascinetto, G
Format: Article
Language:English
Subjects:
Child
Child, Preschool
Early Diagnosis
Epstein-Barr Virus Infections - diagnosis
Female
Graft Rejection - prevention & control
Herpesvirus 4, Human - isolation & purification
Humans
Immunosuppression - adverse effects
Liver Transplantation - adverse effects
Lymphoma - prevention & control
Lymphoproliferative Disorders - prevention & control
Male
Opportunistic Infections - prevention & control
Polymerase Chain Reaction
Postoperative Complications - prevention & control
Retrospective Studies
Surgery
Viral Load
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Summary:Abstract This is a cohort, retrospective, comparative study of all liver transplant recipients from a single center, from May 1998 to July 2015. Patients were divided into two groups according to the type of Epstein-Barr viral load monitoring. For group I (1998–2007), polymerase chain reaction (PCR) was not available or it was only qualitative with limited access. For group II (2008–2015), we used periodically scheduled quantitative PCR in plasma and leukocytes, with aggressive tapering of immunosuppression as soon as viral replication was detected. Ninety-eight recipients were included, 41 (41.8%) were Epstein-Barr virus (EBV) − seronegative before liver transplantation (LT). EBV replication was confirmed in 74 patients (75.5%), being more frequent in seronegative (87.8%) than seropositive patients (66.6%). Eight recipients (8.1%) developed post-transplantation lymphoproliferative disorder (PTLD) on average at 14.3 months post-LT, seven of eight were 
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2016.02.031