Induction of pre-transplant Epstein-Barr virus (EBV) infection by donor blood transfusion in EBV-seronegative recipients may reduce risk of post-transplant lymphoproliferative disease in adolescent renal transplant patients: report of two cases.
BACKGROUND
Post-transplant lymphoproliferative disease (PTLD) is a life-threatening complication following organ transplantation. The greatest risk is seen in Epstein-Barr virus (EBV)-seronegative patients receiving allografts from EBV-seropositive donors. We demonstrate a new approach of pre-transplant prophylaxis of EBV-related PTLD, suggesting that, prior to living-related renal transplantation, blood transfusion from an EBV-seropositive donor to an EBV-seronegative recipient could induce primary EBV infection in the recipient, developing EBV immunity and decreasing risk of PTLD.


METHODS
Recipients underwent weekly donor-specific blood transfusion (3 x 100 mL) before transplantation. EBV-mRNA expression, viral load, serological tests, and clinical signs of EBV infection were assessed following blood transfusion.


RESULTS
We explored a new approach in 2 young EBV-seronegative renal allograft recipients. Both patients developed primary EBV infection following blood transfusion before transplantation and showed symptom-free seroconversion post-transplantation without persistent EBV activation. There were no signs of PTLD during 5-year follow-up.


CONCLUSIONS
A new effective and inexpensive approach is suggested for development of EBV immunity and probably for prophylaxis of EBV-associated PTLD.
Babel
N
N
Interdisciplinary Transplant Research Laboratory, Charité University Medicine, Berlin, Germany. nina.babel@charite.de
Gabdrakhmanova
L
L
Hammer
M
M
Rosenberger
C
C
Oppert
M
M
Volk
H-D
HD
Reinke
P
P
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D001782:Blood Donors; D001803:Blood Transfusion; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000276:immunology* / Q000821:virology; D004854:Herpesvirus 4, Human / Q000276:immunology / Q000472:pathogenicity; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000276:immunology / Q000517:prevention & control*; D008297:Male; D012307:Risk Factors
D000914:Antibodies, Viral