Post‐transplant lymphoproliferative disorder associated Epstein‐Barr virus DNAemia after liver transplantation in children: Experience from single center
The most prevalent malignancy that complicates both adult and pediatric solid organ transplantation is post‐transplant lymphoproliferative disorder (PTLD). This study aimed to analyze the clinical and pathological characteristics, treatments, and outcomes of Epstein‐Barr virus (EBV) DNAemia and PTLD...
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| creator | Dogan, Barut Sema, Yildirim Arslan Bora, Kunay Veysel, Umman Benan, Dernek Ezgi, Kıran Taşçı Gozde, Akkus Kayali Demir, Derya Ozsan, Nazan Hekimgil, Mine Zumrut, Sahbudak Bal Miray, Karakoyun Funda, Cetin Sema, Aydogdu |
| description | The most prevalent malignancy that complicates both adult and pediatric solid organ transplantation is post‐transplant lymphoproliferative disorder (PTLD). This study aimed to analyze the clinical and pathological characteristics, treatments, and outcomes of Epstein‐Barr virus (EBV) DNAemia and PTLD in pediatric liver transplant recipients. A retrospective chart review was performed on 112 patients less than 18 years of age who underwent isolated orthotopic liver transplantation (OLT) between 2010 and 2022 at Ege University Children's Hospital. Data gathered for 1‐year post‐OLT included age at OLT, EBV, immunoglobulin (Ig)M/IgG status of the donor and recipient, indication for OLT, induction regimen, all immunosuppression levels, date and result of EBV polymerase chain reaction testing, rejection episodes documented by liver biopsy, and the development of PTLD. Forty‐nine patients (43.75%) developed EBV DNAemia (median interval from surgery: 2 months, min–max: 2–36), of which 43 (87.8%) grafts came from living donors, and 6 (12.2%) came from deceased donors. Nine (18.4%) patients died during follow‐up, and eight (16.3%) developed PTLD. Of these 8 patients; five patients developed EBV‐related disease, one child developed hemophagocytic lymphohistiocytosis, one developed aplastic anemia, and one child developed B cell lymphoma. When PTLD patients and without‐PTLD patients were compared, pediatric intensive care unit hospitalization, abnormal bone marrow biopsy findings, lymphadenopathy, age at diagnosis of EBV DNAemia, EBV viral load, tacrolimus (FK 506) pre‐infection, were higher and tacrolimus 1‐month levels were lower in patients with PTLD (p |
| doi_str_mv | 10.1002/jmv.29767 |
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This study aimed to analyze the clinical and pathological characteristics, treatments, and outcomes of Epstein‐Barr virus (EBV) DNAemia and PTLD in pediatric liver transplant recipients. A retrospective chart review was performed on 112 patients less than 18 years of age who underwent isolated orthotopic liver transplantation (OLT) between 2010 and 2022 at Ege University Children's Hospital. Data gathered for 1‐year post‐OLT included age at OLT, EBV, immunoglobulin (Ig)M/IgG status of the donor and recipient, indication for OLT, induction regimen, all immunosuppression levels, date and result of EBV polymerase chain reaction testing, rejection episodes documented by liver biopsy, and the development of PTLD. Forty‐nine patients (43.75%) developed EBV DNAemia (median interval from surgery: 2 months, min–max: 2–36), of which 43 (87.8%) grafts came from living donors, and 6 (12.2%) came from deceased donors. Nine (18.4%) patients died during follow‐up, and eight (16.3%) developed PTLD. Of these 8 patients; five patients developed EBV‐related disease, one child developed hemophagocytic lymphohistiocytosis, one developed aplastic anemia, and one child developed B cell lymphoma. When PTLD patients and without‐PTLD patients were compared, pediatric intensive care unit hospitalization, abnormal bone marrow biopsy findings, lymphadenopathy, age at diagnosis of EBV DNAemia, EBV viral load, tacrolimus (FK 506) pre‐infection, were higher and tacrolimus 1‐month levels were lower in patients with PTLD (p < 0.05). In logistic regression analysis, we showed that the age at diagnosis of EBV DNAemia was significantly higher in children with PTLD (p = 0.045; OR: 1.389; 95% CI: 1.007–1.914). PTLD is a rare but severe complication associated with EBV after OLT. This study demonstrated that PTLD is associated with older age, higher tacrolimus blood levels before EBV DNAemia, and higher peak EBV viral load at 1 month of EBV DNAemia.</description><identifier>ISSN: 0146-6615</identifier><identifier>ISSN: 1096-9071</identifier><identifier>EISSN: 1096-9071</identifier><identifier>DOI: 10.1002/jmv.29767</identifier><identifier>PMID: 38932460</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Age ; Anemia ; Aplastic anemia ; B-cell lymphoma ; Biopsy ; Blood levels ; Bone marrow ; Child ; Child, Preschool ; Children ; Diagnosis ; DNA, Viral - blood ; Epstein-Barr Virus Infections - complications ; Epstein-Barr Virus Infections - virology ; Epstein‐Barr virus ; Female ; Graft rejection ; Herpesvirus 4, Human - genetics ; Histiocytosis ; Humans ; Immunoglobulin G ; Immunosuppression ; Infant ; Liver ; Liver diseases ; Liver transplantation ; Liver Transplantation - adverse effects ; Liver transplants ; Lymphadenopathy ; Lymphatic diseases ; Lymphocytes ; Lymphocytosis ; Lymphoma ; Lymphoproliferative Disorders - etiology ; Lymphoproliferative Disorders - virology ; Male ; Malignancy ; Patients ; Peak load ; pediatric liver transplantation ; Pediatrics ; Polymerase chain reaction ; Posttransplant lymphoproliferative disorders ; post‐transplant lymphoproliferative disorder ; Regression analysis ; Retrospective Studies ; Tacrolimus ; Transplantation ; Viruses</subject><ispartof>Journal of medical virology, 2024-06, Vol.96 (6), p.e29767-n/a</ispartof><rights>2024 The Author(s). published by Wiley Periodicals LLC.</rights><rights>2024 The Author(s). Journal of Medical Virology published by Wiley Periodicals LLC.</rights><rights>2024. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). 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This study aimed to analyze the clinical and pathological characteristics, treatments, and outcomes of Epstein‐Barr virus (EBV) DNAemia and PTLD in pediatric liver transplant recipients. A retrospective chart review was performed on 112 patients less than 18 years of age who underwent isolated orthotopic liver transplantation (OLT) between 2010 and 2022 at Ege University Children's Hospital. Data gathered for 1‐year post‐OLT included age at OLT, EBV, immunoglobulin (Ig)M/IgG status of the donor and recipient, indication for OLT, induction regimen, all immunosuppression levels, date and result of EBV polymerase chain reaction testing, rejection episodes documented by liver biopsy, and the development of PTLD. Forty‐nine patients (43.75%) developed EBV DNAemia (median interval from surgery: 2 months, min–max: 2–36), of which 43 (87.8%) grafts came from living donors, and 6 (12.2%) came from deceased donors. Nine (18.4%) patients died during follow‐up, and eight (16.3%) developed PTLD. Of these 8 patients; five patients developed EBV‐related disease, one child developed hemophagocytic lymphohistiocytosis, one developed aplastic anemia, and one child developed B cell lymphoma. When PTLD patients and without‐PTLD patients were compared, pediatric intensive care unit hospitalization, abnormal bone marrow biopsy findings, lymphadenopathy, age at diagnosis of EBV DNAemia, EBV viral load, tacrolimus (FK 506) pre‐infection, were higher and tacrolimus 1‐month levels were lower in patients with PTLD (p < 0.05). In logistic regression analysis, we showed that the age at diagnosis of EBV DNAemia was significantly higher in children with PTLD (p = 0.045; OR: 1.389; 95% CI: 1.007–1.914). PTLD is a rare but severe complication associated with EBV after OLT. This study demonstrated that PTLD is associated with older age, higher tacrolimus blood levels before EBV DNAemia, and higher peak EBV viral load at 1 month of EBV DNAemia.</description><subject>Adolescent</subject><subject>Age</subject><subject>Anemia</subject><subject>Aplastic anemia</subject><subject>B-cell lymphoma</subject><subject>Biopsy</subject><subject>Blood levels</subject><subject>Bone marrow</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Diagnosis</subject><subject>DNA, Viral - blood</subject><subject>Epstein-Barr Virus Infections - complications</subject><subject>Epstein-Barr Virus Infections - virology</subject><subject>Epstein‐Barr virus</subject><subject>Female</subject><subject>Graft rejection</subject><subject>Herpesvirus 4, Human - genetics</subject><subject>Histiocytosis</subject><subject>Humans</subject><subject>Immunoglobulin G</subject><subject>Immunosuppression</subject><subject>Infant</subject><subject>Liver</subject><subject>Liver diseases</subject><subject>Liver transplantation</subject><subject>Liver Transplantation - 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This study aimed to analyze the clinical and pathological characteristics, treatments, and outcomes of Epstein‐Barr virus (EBV) DNAemia and PTLD in pediatric liver transplant recipients. A retrospective chart review was performed on 112 patients less than 18 years of age who underwent isolated orthotopic liver transplantation (OLT) between 2010 and 2022 at Ege University Children's Hospital. Data gathered for 1‐year post‐OLT included age at OLT, EBV, immunoglobulin (Ig)M/IgG status of the donor and recipient, indication for OLT, induction regimen, all immunosuppression levels, date and result of EBV polymerase chain reaction testing, rejection episodes documented by liver biopsy, and the development of PTLD. Forty‐nine patients (43.75%) developed EBV DNAemia (median interval from surgery: 2 months, min–max: 2–36), of which 43 (87.8%) grafts came from living donors, and 6 (12.2%) came from deceased donors. Nine (18.4%) patients died during follow‐up, and eight (16.3%) developed PTLD. Of these 8 patients; five patients developed EBV‐related disease, one child developed hemophagocytic lymphohistiocytosis, one developed aplastic anemia, and one child developed B cell lymphoma. When PTLD patients and without‐PTLD patients were compared, pediatric intensive care unit hospitalization, abnormal bone marrow biopsy findings, lymphadenopathy, age at diagnosis of EBV DNAemia, EBV viral load, tacrolimus (FK 506) pre‐infection, were higher and tacrolimus 1‐month levels were lower in patients with PTLD (p < 0.05). In logistic regression analysis, we showed that the age at diagnosis of EBV DNAemia was significantly higher in children with PTLD (p = 0.045; OR: 1.389; 95% CI: 1.007–1.914). PTLD is a rare but severe complication associated with EBV after OLT. This study demonstrated that PTLD is associated with older age, higher tacrolimus blood levels before EBV DNAemia, and higher peak EBV viral load at 1 month of EBV DNAemia.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38932460</pmid><doi>10.1002/jmv.29767</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-6333-8856</orcidid><orcidid>https://orcid.org/0000-0003-1760-7346</orcidid><orcidid>https://orcid.org/0000-0002-9454-4521</orcidid><orcidid>https://orcid.org/0000-0002-6533-6256</orcidid><orcidid>https://orcid.org/0000-0001-5842-0292</orcidid><orcidid>https://orcid.org/0000-0002-5776-4277</orcidid><orcidid>https://orcid.org/0000-0002-7394-1392</orcidid><orcidid>https://orcid.org/0000-0001-7844-972X</orcidid><orcidid>https://orcid.org/0000-0001-9189-8220</orcidid><orcidid>https://orcid.org/0000-0001-6479-7301</orcidid><orcidid>https://orcid.org/0000-0003-2240-4092</orcidid><orcidid>https://orcid.org/0000-0002-4662-4252</orcidid><orcidid>https://orcid.org/0000-0002-9577-5815</orcidid><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_proquest_miscellaneous_3072813856 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adolescent Age Anemia Aplastic anemia B-cell lymphoma Biopsy Blood levels Bone marrow Child Child, Preschool Children Diagnosis DNA, Viral - blood Epstein-Barr Virus Infections - complications Epstein-Barr Virus Infections - virology Epstein‐Barr virus Female Graft rejection Herpesvirus 4, Human - genetics Histiocytosis Humans Immunoglobulin G Immunosuppression Infant Liver Liver diseases Liver transplantation Liver Transplantation - adverse effects Liver transplants Lymphadenopathy Lymphatic diseases Lymphocytes Lymphocytosis Lymphoma Lymphoproliferative Disorders - etiology Lymphoproliferative Disorders - virology Male Malignancy Patients Peak load pediatric liver transplantation Pediatrics Polymerase chain reaction Posttransplant lymphoproliferative disorders post‐transplant lymphoproliferative disorder Regression analysis Retrospective Studies Tacrolimus Transplantation Viruses |
| title | Post‐transplant lymphoproliferative disorder associated Epstein‐Barr virus DNAemia after liver transplantation in children: Experience from single center |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-02T09%3A28%3A21IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Post%E2%80%90transplant%20lymphoproliferative%20disorder%20associated%20Epstein%E2%80%90Barr%20virus%20DNAemia%20after%20liver%20transplantation%20in%20children:%20Experience%20from%20single%20center&rft.jtitle=Journal%20of%20medical%20virology&rft.au=Dogan,%20Barut&rft.date=2024-06&rft.volume=96&rft.issue=6&rft.spage=e29767&rft.epage=n/a&rft.pages=e29767-n/a&rft.issn=0146-6615&rft.eissn=1096-9071&rft_id=info:doi/10.1002/jmv.29767&rft_dat=%3Cproquest_cross%3E3072813856%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3072487637&rft_id=info:pmid/38932460&rfr_iscdi=true |