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Seropositivity for cytomegalovirus and PCR‐EBV monitoring: Protective factors for posttransplant lymphoproliferative disorder in pediatric liver transplant.
In: Pediatric Transplantation, Jg. 26 (2022-06-01), Heft 4, S. 1-9
Online
academicJournal
Zugriff:
Background: PTLD is a clinical condition with high mortality. Monitoring EBV replication can be a useful tool to avoid the development of PTLD. Materials and Methods: This was a retrospective analysis of 428 pediatric patients who underwent liver transplantation between 1989 and 2016. The patients were divided into 2 groups (transplanted before 2006, when PCR‐EBV was not monitored, and after 2006, when PCR‐EBV monitoring was started). Patients with continuous PCR measurements for EBV were evaluated for the impact of a reduction in immunosuppression or a change in immunosuppressants on the number of viral copies. A logistic regression model was applied to evaluate factors related to PTLD. Results: The prevalence of PTLD was 4.2%. After monitoring patients with PCR for EBV levels, a predominance of the most severe, monomorphic form of lymphoproliferative disorder was observed (p =.009). The PTLD mortality was 5%. There was a change in the PCR level after tacrolimus reduction (p =.002) and after tacrolimus exchange for mTOR (p =.008). The number of EBV copies was significantly higher (p =.029) in patients who developed PTLD. In the multiple regression model, seropositivity for CMV was an independent protective factor for lymphoproliferative disorder (OR=0.09; 95% CI 0.02–0.42), reducing the chance of having PTLD adjusted by serology for EBV by 91%. Conclusions: Monitoring the EBV viral load by PCR seems to prevent the emergence of milder forms of lymphoproliferative disorder. Pretransplant seropositivity for CMV is a protective factor for PTLD. [ABSTRACT FROM AUTHOR]
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Titel: |
Seropositivity for cytomegalovirus and PCR‐EBV monitoring: Protective factors for posttransplant lymphoproliferative disorder in pediatric liver transplant.
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Autor/in / Beteiligte Person: | Éboli, Lígia Patrícia de Carvalho Batista ; Tannuri, Ana Cristina Aoun ; Tannuri, Uenis |
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Zeitschrift: | Pediatric Transplantation, Jg. 26 (2022-06-01), Heft 4, S. 1-9 |
Veröffentlichung: | 2022 |
Medientyp: | academicJournal |
ISSN: | 1397-3142 (print) |
DOI: | 10.1111/petr.14226 |
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