Management and Incidence of EBV Infection in Children after Liver Transplantation Treated With Tacrolimus

Authors: Borgnia D*, Dip M, Arrieta W, Viale D, Halac E, Aredes D, Cervio G, Martinito R, Sarkis C , Bosaleh A, Lencina A, Nuñez A, and Imventarza O

DOI: 10.23880/ijtps-16000103

Volume 1, Issue 1

Abstract

Posttransplant lymphoproliferative disorder (PTLD) causes significant morbidity and mortality in pediatric liver transplantation recipients.

Objective: To describe the management and outcome of patient with EBV infection diagnosed using quantitative competitive polymerase chain reaction.

Materials and Methods: Retrospective descriptive study of 80 pediatric liver transplantations performed between 2009 and 2012 at the Hospital de Pediatría Prof. “Dr. Juan P. Garrahan” in Argentina. Median time of follow-up was 21.5 months (r: 3.6 to 40).

Results: 38.7% (31/80) of patients developed EBV infection. The rate of acute rejection in patients with EBV infection was 64.5% (20/31). Four patients (4.3%) developed PTLD and were treated with rituximab. In this series, overall patient survival was 96%. One death was related to PTLD (1/4).

Conclusion: Viral load monitoring and preventive immunomodulation are safe and effective management strategy patients with EBV infection. Children under two years of age, EBV-naive recipients, and those who develop more rejection episodes are at risk of PTLD.

Keywords: Epstein-Barr virus (EBV); Liver transplantation; Pediatric; Post-transplant lymphoproliferative disorder (PTLD)

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