Prospective longitudinal analysis of quantitative Epstein-Barr virus polymerase chain reaction in pediatric liver transplant recipients.
BACKGROUND
Posttransplant lymphoproliferative disease (PTLD) remains a significant cause of morbidity and mortality in pediatric liver transplant recipients. Epstein-Barr Virus (EBV) mismatch associated with more prevalent use of split-liver, reduced size, and living-related transplants has increased the risk of primary EBV infection and subsequent PTLD. Early identification of EBV viremia may reduce the risk of PTLD, because it allows for early adjustment of immunosuppression and antiviral therapy.


METHODS
EBV viral load was measured monthly by quantitative competitive polymerase chain reactions in three pediatric liver transplant recipients.


RESULTS
Onset of EBV viremia was documented in one recipient. Established EBV viremia was followed in the other two recipients (one with chronic rejection and one with PTLD) who were initially tested once monitoring was initiated in our program.


CONCLUSIONS
EBV quantitative competitive polymerase chain reactions may represent a promising way to follow EBV viral load and potentially prevent the development of PTLD.
Kogan
D L
DL
Division of Pediatric Gastroenterology, Mount Sinai Medical Center, New York, New York 10029, USA.
Burroughs
M
M
Emre
S
S
Fishbein
T
T
Moscona
A
A
Ramson
C
C
Shneider
B L
BL
D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000209:etiology; D005260:Female; D006084:Graft Rejection / Q000150:complications; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D008137:Longitudinal Studies; D008232:Lymphoproliferative Disorders / Q000150:complications / Q000209:etiology; D008297:Male; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications; D011184:Postoperative Period; D011446:Prospective Studies; D019562:Viral Load; D014766:Viremia / Q000150:complications / Q000209:etiology