Chronic High Epstein-Barr Viral Load Carriage in Pediatric Kidney Transplant Recipients.
1Pediatrics, Children's Hospital of Pittsburgh, Pittsburgh, PA
2Surgery, University of Pittsburgh, Pittsburgh, PA.
Meeting: 2016 American Transplant Congress
Abstract number: B298
Keywords: Epstein-Barr virus (EBV), Kidney transplantation, Pediatric, Post-transplant lymphoproliferative disorder (PTLD)
Session Information
Date: Sunday, June 12, 2016
Session Name: Poster Session B: PTLD/Malignancies: All Topics
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background
The development of Epstein-Barr virus (EBV) infection and post-transplant lymphoproliferative disorder (PTLD) is normally associated with a high EBV viral load in peripheral blood. Observations from our center have previously identified existence of a chronic EBV high load carrier state (CHL) which demonstrated variable outcomes based upon the organ which was transplanted. Data defining the incidence and outcome of CHL in pediatric kidney transplantation (KTx) are not well described.
Methods:
The charts of children undergoing isolated KTx at Children's Hospital of Pittsburgh between January 2000 and December 2014 were retrospectively reviewed. EBV loads in the peripheral blood were routinely measured as part of surveillance protocols at our center. CHL was defined as the presence of high load for >50% of samples for ≥6 months following either asymptomatic state or complete clinical resolution of EBV disease/PTLD. PTLD was defined histologically using WHO definitions.
Results:
Of 209 isolated KTx patients, a total of 13 (6%) children with CHL were identified. Pre-transplant serologies were available on all these children and 12/13 (92%) were EBV negative prior to transplant. 8/12 (66%) children with CHL developed primary EBV infection within the first year after transplant (the median of 29.5 weeks; 3-291). 4 of these 13 children developed CHL at the time of their primary EBV infection. The median duration of CHL was 49 weeks (8-196) and 12/13 (92%) had spontaneous resolution. Two children have had more than one episode of CHL.
Overall incidence of PTLD was 2/209 (1%) and none of children with CHL developed PTLD.
CHL in KTx does not appear to increase the risk of late onset PTLD. These data provide important information about the outcome of chronic EBV high load carriage in pediatric KTx recipients.
CITATION INFORMATION: Yamada M, Fadaker P, Nguyen C, Ganoza A, Humar A, Michaels M, Green M. Chronic High Epstein-Barr Viral Load Carriage in Pediatric Kidney Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Yamada M, Fadaker P, Nguyen C, Ganoza A, Humar A, Michaels M, Green M. Chronic High Epstein-Barr Viral Load Carriage in Pediatric Kidney Transplant Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/chronic-high-epstein-barr-viral-load-carriage-in-pediatric-kidney-transplant-recipients/. Accessed March 31, 2020.« Back to 2016 American Transplant Congress