Epstein-Barr viral loads do not predict post-transplant lymphoproliferative disorder in pediatric lung transplant recipients: A multicenter prospective cohort study

the Clinical Trials in Organ Transplantation in Children (CTOTC-03)

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5 Scopus citations

Abstract

Prediction of PTLD after pediatric lung transplant remains difficult. Use of EBV VL in WB has been poorly predictive, while measurement of VL in BAL fluid has been suggested to have enhanced utility. The NIH-sponsored Clinical Trials in Organ Transplantation in Children (CTOTC-03) prospectively obtained serial quantitative measurements of EBV PCR in both WB and BAL fluid after pediatric lung transplantation. Descriptive statistics, contingency analyses, and Kaplan-Meier analyses evaluated possible association between EBV and PTLD. Of 61 patients, 34 (56%) had an EBV+PCR (at least once in WB or BAL). EBV donor (D)+patients more often had a positive PCR (D+/recipient (R)−: 13/18; D+/R+: 14/23) compared to EBV D- patients (6/17). Several D−/R− (5/12) patients developed EBV, but none developed PTLD. All four PTLD patients were D+/R− with EBV+PCR. Neither the time to first EBV+PCR nor the CT for PCR positivity in BAL or WB was statistically different between those with and without PTLD. Having an EBV-seropositive donor was associated with increased risk of EBV+PCR in WB. EBV load in BAL was not predictive of PTLD.

Original languageEnglish (US)
Article numbere13011
JournalPediatric transplantation
Volume21
Issue number6
DOIs
StatePublished - Sep 2017
Externally publishedYes

Bibliographical note

Funding Information:
This research was performed as a project of the Clinical Trials in Organ Transplantation in Children a collaborative clinical research project headquartered at the National Institute of Allergy and Infectious Diseases (U01 Grant AI077810 awarded to S. Sweet). The CTOT-03 consortium members thank the following personnel for the support of the work: Boston Children's Hospital, Boston MA: Dawei Jiang; Children's Hospital of Philadelphia: Rosa Kim, Sara Nguyen; Lucile Packard Children's Hospital at Stanford, Palo Alto, CA: Elisabeth Merkel; Nationwide Children's Hospital, Columbus, OH: Todd Astor, Stephen Kirkby, Ashley Nance, Kerri Nicholson, Susan Meyer; St. Louis Children's Hospital, St. Louis, MO: Colleen Eisenbarger; Texas Children's Hospital, Houston, TX: George Mallory, Mea Ebenbichler.

Publisher Copyright:
© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Keywords

  • bronchoalveolar lavage
  • Epstein-Barr virus
  • lung transplantation
  • pediatrics
  • post-transplant lymphoproliferative disorder

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