Epstein-Barr virus (EBV) poses a significant threat to patient and graft survival post-transplant. We hypothesized that recipients who shed EBV at transplant had less immunologic control of the virus and hence were more likely to have active EBV infection and disease post-transplant. To test this hypothesis, we conducted a 5-year prospective study in primary solid organ transplant recipients. We measured EBV DNA in oral washes and blood samples by quantitative PCR before transplant and periodically thereafter for up to 4 years. Pre-transplant samples were available from 98 subjects. EBV DNA was detected pre-transplant in 32 of 95 (34%) and 5 of 93 subjects (5%) in oral wash and blood, respectively. Recipients with and without detectable pre-transplant EBV DNA were not significantly different demographically and had no significant difference in patient and graft survival (P =.6 for both comparisons) or post-transplant EBV viremia-free survival (P =.8). There were no cases of EBV-related disease or post-transplant lymphoproliferative disorder (PTLD) in any of the patients with detectable EBV DNA pre-transplant. In conclusion, detectable EBV DNA pre-transplant was not associated with differences in patient/graft survival, post-transplant EBV viremia, or EBV-related diseases including PTLD.
Bibliographical noteFunding Information:
Demographic and clinical data on infections, graft, and subject outcomes were obtained from the database of prospectively recorded demographics and outcome data for all transplants performed at the University of Minnesota. This study was approved by the Research Subjects Protection Program of the University of Minnesota (IRB # 0804M31463), and informed consent was obtained from recipients before participation.
This study was supported by grants from the National Institutes of Health (2PO1 DK13083), the University of Minnesota International Center for Antiviral Research and Epidemiology, and the University of Minnesota Foundation
© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
- EBV viremia
- pre-transplant EBV
- viral complications of transplant