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Viral load of EBV DNAemia is a predictor of EBV-related post-transplant lymphoproliferative disorders in pediatric renal transplant recipients

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An Erratum to this article was published on 10 July 2017

Abstract

Background

Post-transplant lymphoproliferative disorder (PTLD) is a severe complication of solid organ transplantation that can be classified into two major subtypes, namely, early lesions and non-early lesions, based on histopathological findings. In the vast majority of cases, proliferating cells are B lymphocytes and, most frequently, proliferation is induced by Epstein–Barr virus (EBV) infection.

Methods

The aim of our study was to evaluate the natural history of EBV infection and its possible evolution toward PTLD in a pediatric cohort of patients who received a renal transplant between January 2000 and December 2013. A total of 304 patients were evaluated for this study, of whom 103 tested seronegative for EBV at transplantation.

Results

Following transplantation, 50 of the 103 seronegative patients (48.5%) developed a first EBV infection, based on the results of PCR assays for EBV DNA, with 19 of these patients ultimately reverting to the negative state (<3000 copies/μl). Among the 201 seropositive patients only 40 (19.9%) presented a reactivation of EBV. Non-early lesions PTLD was diagnosed in ten patients, and early lesions PTLD was diagnosed in five patients. In all cases a positive EBV viral load had been detected at some stage of the follow-up. Having a maximum peak of EBV viral load above the median value observed in the whole cohort (59,909.5 copies/μl) was a significant and independent predictor of non-early lesions PTLD and all PTLD onset.

Conclusions

A high PCR EBV viral load is correlated with the probability of developing PTLD. The definition of a reliable marker is essential to identify patients more at risk of PTLD and to personalize the clinical approach to the single patient.

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Contribution of each author to the manuscript

EC, IG, LM, and LDS participated in research design; EC, IG, LB, LM, FL, MCDA, and LDS participated in the writing of the paper; EC, FM, GL, CR, AL, and PM participated in carrying our the research, and SP, MCDA, EC, IG, LM, FL, and LDS participated in data analysis

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Authors and Affiliations

  1. Pediatric Nephrology and Renal Transplant Unit, Bambino Gesù Children’s Hospital–IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy

    Elisa Colombini, Isabella Guzzo, Federica Morolli & Luca Dello Strologo

  2. Pediatric Nephrology, Dialysis and Transplantation Unit, Department of Pediatrics, University of Padova, Padova, Italy

    Germana Longo & Luisa Murer

  3. Virology Unit, Bambino Gesù Children’s Research Hospital–IRCCS, Rome, Italy

    Cristina Russo

  4. Hematology and Oncology, Bambino Gesù Children’s Research Hospital–RCCS, Rome, Italy

    Alessandra Lombardi, Pietro Merli & Franco Locatelli

  5. Department of Molecular Medicine, University of Padua, Padua, Italy

    Luisa Barzon

  6. Unit of Clinical Epidemiology, Bambino Gesù Children’s Research Hospital–IRCCS, Rome, Italy

    Simone Piga & Marta Luisa Ciofi degli Atti

  7. University of Pavia, Pavia, Italy

    Franco Locatelli

Authors
  1. Elisa Colombini
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  2. Isabella Guzzo
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  3. Federica Morolli
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  8. Luisa Barzon
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  13. Luca Dello Strologo
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Corresponding author

Correspondence to Luca Dello Strologo.

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Ethics

The study was approved by the OPBG Ethical Committee with a waiver of informed consent (study number: 1183-OPBG 2016).

Conflict of interest

The authors declare no conflicts of interest.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s00467-017-3752-y.

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Colombini, E., Guzzo, I., Morolli, F. et al. Viral load of EBV DNAemia is a predictor of EBV-related post-transplant lymphoproliferative disorders in pediatric renal transplant recipients. Pediatr Nephrol 32, 1433–1442 (2017). https://doi.org/10.1007/s00467-017-3627-2

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  • DOI: https://doi.org/10.1007/s00467-017-3627-2

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