Detection of Epstein-Barr virus DNA in sequential renal transplant biopsy specimens using the polymerase chain reaction. Report of a patient with a posttransplant lymphoproliferative disorder.
The polymerase chain reaction was used to retrospectively examine frozen and paraffin-embedded tissue from four sequential renal biopsy specimens, a pretransplant skin biopsy specimen, a postauricular lymph node, and an allograft nephrectomy specimen for the presence of Epstein-Barr virus (EBV) DNA in a 29-year-old man who developed diffuse lymphadenopathy 2 months after a cadaveric renal transplant. The EBV primers used amplify a 245-base pair fragment of the EBV IR3 sequence and were run in parallel with a pair of human beta-globin gene primers as positive DNA integrity controls. Epstein-Barr virus DNA was detected in three of the four renal allograft biopsy specimens, the post-auricular lymph node, and the renal allograft nephrectomy specimen. Initial detection occurred 34 days posttransplant and 23 days prior to the diagnosis of posttransplant lymphoproliferative disorder. Examination of a skin biopsy specimen obtained prior to transplantation and of the initial posttransplant renal allograft biopsy specimen 15 days posttransplant did not demonstrate EBV DNA. The findings of serologic studies performed at the time of diagnosis of the posttransplant lymphoproliferative disorder suggested a remote EBV infection. These results further demonstrate the association of EBV with posttransplant lymphoproliferative disorder and suggest a possible role for polymerase chain reaction in the early detection of EBV in transplant patients. Larger retrospective studies are needed to determine the prognostic significance of EBV DNA found in routine renal allograft biopsy specimens.
Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City 52242.
D J
DJ
Lager
D D
DD
Slagel
L J
LJ
Burgart
D000328:Adult; D001483:Base Sequence; D001706:Biopsy; D004279:DNA, Viral / Q000032:analysis*; D004854:Herpesvirus 4, Human / Q000235:genetics*; D006801:Humans; D007668:Kidney / Q000382:microbiology*; D016030:Kidney Transplantation; D008232:Lymphoproliferative Disorders / Q000209:etiology / Q000382:microbiology*; D008297:Male; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications
D004279:DNA, Viral