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. 2022 Oct 18;17(10):e0269766.
doi: 10.1371/journal.pone.0269766. eCollection 2022.

Epstein-Barr Virus DNAemia and post-transplant lymphoproliferative disorder in pediatric solid organ transplant recipients

Yeh-Chung Chang  1 , Rebecca R Young  1 , Alisha M Mavis  2 , Eileen T Chambers  3 , Sonya Kirmani  4 , Matthew S Kelly  1 , Ibukunoluwa C Kalu  1 , Michael J Smith  1 , Debra J Lugo  1
Affiliations

Epstein-Barr Virus DNAemia and post-transplant lymphoproliferative disorder in pediatric solid organ transplant recipients

Yeh-Chung Chang et al. PLoS One. .

Abstract

Background: Pediatric solid organ transplant (SOT) recipients commonly have Epstein-Barr virus (EBV) DNAemia and are at risk of developing post-transplant lymphoproliferative disorder (PTLD). EBV DNAemia has not been analyzed on a continuous scale in this population.

Methods: All children ≤ 18 years of age who underwent SOT at a single center between January 1, 2007 and July 31, 2018 were included in this retrospective study. Transplant episodes in which PTLD occurred were compared to transplant episodes without PTLD. Multivariable logistic regression was used to identify factors associated with the development of EBV DNAemia and maximum height of EBV DNAemia. A Cox proportional hazards model was used to calculate hazard ratios for time to PTLD.

Results: Of 275 total transplant recipients and 294 transplant episodes, there were 14 episodes of PTLD. Intestinal and multivisceral transplant were strongly associated with PTLD (p = 0.002). Risk factors for the development of EBV DNAemia include donor and recipient positive EBV serologies (p = 0.001) and older age (p = 0.001). Maximum level of EBV DNAemia was significantly associated with development of PTLD (p<0.0001). Every one log (log10) increase in the maximum level of EBV DNAemia was associated with a more than doubling of the hazard on developing PTLD (HR: 2.18, 95% CI 1.19-3.99).

Conclusions: Transplant type was strongly associated with development of PTLD in pediatric SOT recipients. EBV serologies and age were associated with the development of EBV DNAemia and height of DNAemia. High levels of EBV DNAemia were strongly associated with an increased hazard for PTLD.

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Conflict of interest statement

The authors have declared that no competing interests exist.

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References

    1. Allen UD, Preiksaitis JK, AST Community of Practice. Post-transplant lymphoproliferative disorders, Epstein-Barr virus infection, and disease in solid organ transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant 2019;33(9): e13652. doi: 10.1111/ctr.13652 - DOI - PubMed
    1. Green M, Michaels MG. Epstein-Barr virus infection and posttransplant lymphoproliferative disorder. Am J Transplant 2013;13 Suppl 3:41–54. doi: 10.1111/ajt.12004 - DOI - PubMed
    1. San-Juan R, Manuel O, Hirsch HH, Fernández-Ruiz M, López-Medrano F, Comoli P, et al.. Current preventive strategies and management of Epstein-Barr virus-related post-transplant lymphoproliferative disease in solid organ transplantation in Europe. Results of the ESGICH Questionnaire-based Cross-sectional Survey. Clin Microbiol Infect 2015;21(6): 604. doi: 10.1016/j.cmi.2015.02.002 - DOI - PubMed
    1. Green M, Webber S. Posttransplantation lymphoproliferative disorders. Pediatr Clin North Am 2003;50(6): 1471–91. doi: 10.1016/s0031-3955(03)00127-5 - DOI - PubMed
    1. Allen UD, Farkas G, Hébert D, Weitzman S, Stephens D, Petric M, et al.. Risk factors for post-transplant lymphoproliferative disorder in pediatric patients: a case-control study. Pediatr Transplant 2005;9(4): 450–5. doi: 10.1111/j.1399-3046.2005.00318.x . - DOI - PubMed

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