title: Effect of early EBV and/or CMV viremia on graft function and acute cellular rejection in pediatric liver transplantation.
abstract: BACKGROUND
  The clinical impact of Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infections in the early post-transplantation period are poorly documented. We investigated the prevalence and timing of EBV and CMV infections during the first 21 d post-transplantation in relation to graft function and acute cellular rejection in a large cohort of pediatric liver transplantation recipients.
  
  
  METHODS
  Clinical, biochemical, virological, and histopathological data of 62 consecutive children who received a liver transplant were reviewed retrospectively.
  
  
  RESULTS
  Seventeen patients (27%) developed EBV and 11 (18%) CMV viremia (mean interval from surgery: 7.6 d, SD 3.6 and 8.7 d, SD 6.4, respectively). EBV and CMV viremia were more common as a consequence of reactivation than of primary infection. EBV viremic recipients had more often abnormal bilirubin levels [p = 0.01; OR 5.8: 95% CI 1.3-25.5]. Acute rejection was diagnosed in 20 recipients (32.3%). No correlation was found between rejection and EBV and CMV serology before transplantation and viremia after transplantation (mean interval between the diagnosis of rejection and the detection of EBV DNA and CMV DNA: one d, SD 4.4 and five d, SD 9.2, respectively).
  
  
  CONCLUSIONS
  EBV and CMV viremia occur at a very early-stage post-transplantation and do not appear to affect the short-term outcome of the transplant.
authors: Paediatric Liver Centre, King's College London School of Medicine, King's College Hospital NHS Foundation Trust, London, UK. g.indolfi@meyer.it
authors: Giuseppe
authors: G
authors: Indolfi
authors: Nigel
authors: N
authors: Heaton
authors: Melvyn
authors: M
authors: Smith
authors: Giorgina
authors: G
authors: Mieli-Vergani
authors: Mark
authors: M
authors: Zuckerman
mesh_terms: D000208:Acute Disease; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D004279:DNA, Viral / Q000235:genetics; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D015774:Ganciclovir / Q000627:therapeutic use; D006084:Graft Rejection / Q000821:virology*; D006085:Graft Survival; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D008107:Liver Diseases / Q000150:complications / Q000601:surgery; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D014766:Viremia / Q000175:diagnosis / Q000209:etiology
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D015774:Ganciclovir