The effect of Epstein-Barr virus infection on medium-term survival after orthotopic heart transplantation.
Our aim was to assess the medium-time results after orthotopic heart transplantation (OHT) depending on the serostatus of heart transplant recipients at the time of transplantation.


METHODS
We enrolled 120 patients in this retrospective study including 107 males and an overall mean age of 49.1 +/- 8.6 years ischemic heart disease (IHD) was the diagnosis before OHT in 46%. The mean follow-up was 48 months. The first diagnostic coronary angiography was routinely preformed at 1 year after OHT, and then every second year. We evaluated every incidence of a change in the coronary arteries, the presence of significant stenosis (requiring percutaneous coronary intervention), acute myocardial infarction, death, or retransplantation. Using indirect immunofluorescence assays we detected Epstein-Barr virus (EBV) antigenemia by identification of antibodies against early antigens of EBV (EA) of IgM and IgG classes as well as IgG antibodies against nuclear antigen of EBV (EBNA). Since April 2001 all three types of antibodies were routinely investigated on admission to the hospital for OHT.


RESULTS
At the time of transplantation, IgM-EA antibodies were detected in 17 (14%) patients, IgG-EA in 35 (29%), and IgG-EBNA in 113 (94%). Survival rate, incidence of cardiac allograft vasculopathy and death, as a function of the serostatus of the heart recipient at the time of transplantation were estimated by Kaplan-Meier curves; the results were compared by log-rank tests. The findings among IgM EA, IgG EA, and IgG EBNA-positive and -negative groups were statistically comparable.


CONCLUSIONS
Infection with EBV before OHT did not worsen the prognosis over the first 4 years after transplantation.
Zakliczyński
M
M
Department of Cardiac Surgery & Transplantation, Silesian Center for Heart Disease, Zabrze, Poland. zaklimed@onet.pl
Krynicka-Mazurek
A
A
Pyka
Ł
Ł
Trybunia
D
D
Nadziakiewicz
P
P
Przybylski
R
R
Zembala
M
M
D000328:Adult; D000956:Antigens, Viral / Q000097:blood*; D003331:Coronary Vessels / Q000473:pathology / Q000821:virology; D020031:Epstein-Barr Virus Infections / Q000097:blood / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D017741:Survivors; D013997:Time Factors
D000956:Antigens, Viral