Timing of epstein-barr virus acquisition and the course of posttransplantation lymphoproliferative disorder in children
Journal
Transplantation
Journal Volume
87
Journal Issue
5
Pages
758-762
Date Issued
2009
Abstract
Background. To investigate the clinical course and risk factors of Epstein-Barr virus (EBV)-associated posttransplantation lymphoproliferative disorder (PTLD) after liver transplantation (LT) among children in Taiwan where children acquired EBV infection in early childhood. Methods. In the retrospective study, 67 children underwent LT in our hospital and survived for more than 3 months were recruited. Various predisposing risk factors, including viral status, nutritional status, age at transplantation, and medications, were assessed. The diagnosis of EBV-associated PTLD in these liver transplanted patients was confirmed by histologic examination. Results. Eight children developed EBV-associated PTLD after LT, and all (100%) had gastrointestinal tract mucosa-associated lymphoid tissue involvement with the initial presentation as bloody stool. The incidence of PTLD is 11.9% (8/67) in the liver transplanted children in our hospital. Children who received LT before 1 year of age had a higher risk of EBV-associated PTLD than others (relative risk [RR]=10.37, P=0.006). The absence of EBV nuclear antigen antibody in recipients before LT also increased the risk (RR=8.63, P=0.018). The RR of EBV-associated PTLD increased to 13.3 (P=0.002) in EBV na?ve children who received LT before 1 year of age. Conclusions. Additional risk of EBV naivity and transplantation age below 1 year was evident in our series to the development of EBV-associated PTLD. Acquired EBV infection in early infancy after the LT may increase the risk of gastrointestinal tract involvement of EBV-associated PTLD in Taiwan. Copyright ? 2009 by Lippincott Williams & Wilkins.
SDGs
Other Subjects
cyclosporin A; ganciclovir; methylprednisolone; tacrolimus; alanine aminotransferase; antivirus agent; ganciclovir; article; child; disease course; Epstein Barr virus; female; gastrointestinal tract; graft rejection; hematochezia; human; liver transplantation; lymphoproliferative disease; major clinical study; male; mucosa associated lymphoid tissue lymphoma; priority journal; risk factor; Taiwan; virus infection; adolescent; blood; cytomegalovirus infection; Epstein Barr virus; graft rejection; infant; liver transplantation; lymphoproliferative disease; preschool child; retrospective study; time; virology; virus infection; Adolescent; Alanine Transaminase; Antiviral Agents; Child; Child, Preschool; Cytomegalovirus Infections; Epstein-Barr Virus Infections; Female; Ganciclovir; Graft Rejection; Herpesvirus 4, Human; Humans; Infant; Liver Transplantation; Lymphoproliferative Disorders; Male; Retrospective Studies; Risk Factors; Time Factors
Type
journal article