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Epstein-Barr virus DNA monitoring in serum and whole blood in pediatric liver transplant recipients who do or do not discontinue immunosuppressive therapy

Journal article
Authors Carola Kullberg-Lindh
Robert Saalman
Michael Olausson
Gustaf Herlenius
Magnus Lindh
Published in Pediatric Transplantation
Volume 21
Issue 5
ISSN 1397-3142
Publication year 2017
Published at Institute of Clinical Sciences, Section for Surgery and Gastrosurgical Research and Education, Department of Surgery
Institute of Clinical Sciences, Section for Surgery and Gastrosurgical Research and Education, Department of Plastic Surgery
Institute of Biomedicine, Department of Infectious Medicine
Institute of Clinical Sciences, Section for the Health of Women and Children, Department of Pediatrics
Language en
Links doi.org/10.1111/petr.12875
Keywords Children, Epstein-Barr virus, Immunosuppression, Liver transplantation, Tolerance
Subject categories Transplantation surgery


© 2016 John Wiley & Sons A/S.The rate of PTLD can be reduced by weaned IS guided by monitoring of EBV DNA. In this single-center retrospective case series study, we analyzed how reduction in IS influenced EBV DNA levels in whole blood and serum in 30 children during the first year after liver transplantation, and how these levels were related to symptoms putatively due to EBV. Primary and reactivated EBV infection was seen in 18 (60%) and eight patients (27%), respectively. Thirteen patients (42%) developed chronic high load the first year post-transplant. IS was successfully discontinued in six patients the first year post-transplant and in another two patients within 3 years. EBV DNA levels were reduced, but persisted long term in all the eight patients who had IS completely withdrawn. There was no case of PTLD. In summary, EBV DNAemia and chronic high load were very common after pediatric liver transplantation. Liver graft tolerance facilitates radical reduction in IS treatment, which may prevent PTLD, but EBV DNAemia may persist long term after discontinued IS.

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