An Incidence of Childhood Epstein-Barr Virus Infection and Lymphoproliferative Disease after Liver Transplantation.
- Author:
Jin Kyong CHUN
1
;
Bo Hwa CHOI
;
Kyung Mo KIM
;
Heung Bum OH
;
Eun Sil YOO
;
Shin HWANG
;
Kwang Min PARK
;
Young Joo LEE
;
Sung Gyu LEE
Author Information
1. Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Epstein-Barr Virus infection;
Posttransplant lymphoproliferative disease;
Liver transplantation;
Child
- MeSH:
Asymptomatic Infections;
Capsid;
Child;
Diagnosis;
Epstein-Barr Virus Infections;
Fatal Outcome;
Herpesvirus 4, Human*;
Humans;
Immunoglobulin G;
Immunoglobulin M;
Immunosuppression;
In Situ Hybridization;
Incidence*;
Liver Transplantation*;
Liver*;
Polymerase Chain Reaction;
Risk Factors;
RNA
- From:The Journal of the Korean Society for Transplantation
1999;13(1):141-148
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Epstein-Barr virus (EBV)-associated disease is known to be one of the major complication after transplantation. Early identification and diagnosis is crucial. The objectives of this study are to evaluate the incidence and to analyze the risk factors of EBV-associated disease. Twenty-five children with liver transplantation from Oct. 1994 to Oct. 1997 had been surveyed. Laboratory data of EBV infection such as anti-viral capsid antigen (VCA) IgM and IgG, EBV PCR, EBV encoded small RNA (EBER) in situ hybridization had been obtained at pre op, and post op 1, 2, 3, 4, 12, 24 weeks, then annually or when EBV infection was suspected. We classified these cases as asymptomatic infection, EBV syndrome, posttransplant lymphoproliferative disease (PTLD). And we analyzed the incidence of EBV infection according to age, type of immunosuppression, and CMV disease. Incidence of EBV infection in this study was 48% (12 out of 25), among them, 5 children were symptomatic and PTLD developed in 2 children. The significant risk factors were age at transplantation and CMV infection. One of PTLD cases resulting from EBV infection showed fatal outcome, the other was improved. We suggested that physicians especially in the care of the children after the liver transplantation should recognize the risk factors of the development of the EBV infection to avoid the progression into the potentially fatal PTLD.
