Pediatric Nephrology

, Volume 17, Issue 9, pp 770–775

Epstein-Barr virus monitoring in paediatric renal transplant recipients

  •  R. Shroff
  •  R. Trompeter
  •  D. Cubitt
  •  U. Thaker
  •  L. Rees
Transplantation

DOI: 10.1007/s00467-002-0931-1

Cite this article as:
Shroff, R., Trompeter, R., Cubitt, D. et al. Pediatr Nephrol (2002) 17: 770. doi:10.1007/s00467-002-0931-1

Abstract.

Prospective Epstein-Barr virus (EBV) surveillance post transplant was undertaken by qualitative polymerase chain reaction testing for EBV DNA in plasma so as to detect EBV viremia as early as possible and thereby attempt to pre-empt post-transplant lymphoproliferative disease by reduction of immunosuppression. Forty-three children (46 transplants) were followed for a median (range) of 15.5 (3–25) months. Thirty-one children (67%) were EBV seropositive pre transplant. Twenty children (44%) developed EBV viremia; of these 9 (60%) were seronegative and 11 (36%) seropositive recipients. Primary infection developed later (median difference 14.2 weeks, P=0.009), was more likely to be symptomatic (odds ratio 2.91, 95% confidence interval 0.95–4.88) and associated with a rise in serum creatinine (odds ratio 6.13, 95% confidence interval 4.13–8.13) than reactivation disease. There was a higher incidence of EBV disease in children receiving quadruple therapy and tacrolimus (odds ratio 13.2, 95% confidence interval 11.5–14.9) compared with those given cyclosporin-based immunosuppression. Immunosuppression was reduced when EBV infection was detected. All children became asymptomatic and renal function returned to normal by a median (range) of 17 (6–52) days, although mild relapses occurred in 3 children. Regular EBV surveillance allowed prompt reduction of immunosuppression and was associated with a good outcome in this group of children.

Renal transplantation Epstein-Barr virus Post-transplant lymphoproliferative disorder Polymerase chain reaction 

Copyright information

© IPNA 2002

Authors and Affiliations

  •  R. Shroff
    • 1
  •  R. Trompeter
    • 1
  •  D. Cubitt
    • 2
  •  U. Thaker
    • 2
  •  L. Rees
    • 1
  1. 1.Department of Nephrology, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK
  2. 2.Department of Virology, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK

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