Introduction: Post-transplant lymphoproliferative disorder (PTLD) is one of the most serious complications of chronic immunosuppression after an organ transplant. One of the major risk factors for early PTLD (within a year after transplantation) is Epstein-Barr Virus (EBV) seronegative status at the time of transplantation.

Methods: Our objective was to evaluate the management of EBV negative patients who received an EBV positive kidney transplant in our department one year after the implementation of an EBV viral load surveillance guideline in 2016.

Results: During the first year following the implementation of our guideline (EBV viral load checked immediately after the transplant, then monthly for 6 months then every 3 months up to one year), 16 EBV seronegative patients received a kidney transplant from an EBV seropositive donor. The median length of follow-up after transplantation was 8 ±4.5 months and 62.5% of our patients (10/16) developed detectable EBV viraemia during this time. In seven out of ten cases (70%) immunosuppression was decreased, and in four patients mycophenolate was discontinued. This was followed in one case by a rejection episode, but in four cases there was a reduction in EBV viral load. Two patients developed symptomatic viraemia but had a negative PET-CT scan and were referred to haematology for further advice. EBV seroconversion was assessed in only five patients but was present in four of them (80%). At completion of follow-up, no patient developed early PTLD and all had a functioning kidney transplant.

Discussion: EBV viral load surveillance in EBV seronegative patients after receipt of a kidney transplant from an EBV seropositive donor assists in tailoring immunosuppression to prevent early PTLD.

CITATION INFORMATION: Dudreuilh C., Asgari E., Hilton R. Follow-Up and Outcomes of Epstein-Barr Virus Negative Recipients after a Kidney Transplant from an Epstein-Barr Virus Positive Donor Am J Transplant. 2017;17 (suppl 3).

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