title: Management of post-transplant Epstein-Barr virus-related lymphoproliferative disease in solid organ and hematopoietic stem cell recipients.
abstract: Epstein-Barr virus (EBV)-related post-transplant lymphoproliferative disease (PTLD) is one of the most serious complications associated with solid organ and hematopoietic stem cell transplantation. PTLD is most frequently seen with primary EBV infection post-transplant, a common scenario for pediatric solid organ recipients. Risk factors for infection or reactivation of EBV following solid organ transplant are stronger immunosuppressive therapy regimens, and being seronegative for receptor. For hematopoietic stem cell transplantation, the risk factors relate to the type of transplant, human leukocyte antigen disparity, the use of stronger immunosuppressants, T-cell depletion, and severe graft-versus-host disease. Mortality is high, and most frequent in patients who develop PTLD in the first six months post-transplant. The primary goal of this article is to provide an overview of the clinical manifestations, diagnosis, accepted therapies, and management of EBV infection in transplant recipients, and to suggest that the adoption of monitoring protocols could contribute to a reduction in related complications.
authors.affiliation: Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Heloisa Helena de Sousa
authors.initials: HH
authors.lastname: Marques
authors.affiliation: Comissão de Infecção em Imunodeprimidos, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Maria Aparecida
authors.initials: MA
authors.lastname: Shikanai-Yasuda
authors.affiliation: Comissão de Infecção em Imunodeprimidos, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Luiz Sérgio Fonseca de
authors.initials: LS
authors.lastname: dAzevedo
authors.affiliation: Comissão de Infecção em Imunodeprimidos, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Hélio Helh
authors.initials: HH
authors.lastname: Caiaffa-Filho
authors.affiliation: Comissão de Infecção em Imunodeprimidos, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Lígia Camera
authors.initials: LC
authors.lastname: Pierrotti
authors.affiliation: Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Maria Zilda de
authors.initials: MZ
authors.lastname: Aquino
authors.affiliation: Comissão de Infecção em Imunodeprimidos, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Marta Heloisa
authors.initials: MH
authors.lastname: Lopes
authors.affiliation: Comissão de Infecção em Imunodeprimidos, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Natalya Zaidan
authors.initials: NZ
authors.lastname: Maluf
authors.affiliation: Comissão de Infecção em Imunodeprimidos, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Silvia Vidal
authors.initials: SV
authors.lastname: Campos
authors.affiliation: Comissão de Infecção em Imunodeprimidos, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Silvia Figueiredo
authors.initials: SF
authors.lastname: Costa
mesh_terms: D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000517:prevention & control / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008232:Lymphoproliferative Disorders / Q000821:virology*; D016377:Organ Transplantation / Q000009:adverse effects*; D012307:Risk Factors
chemical_list: D007166:Immunosuppressive Agents