Epstein-Barr virus-associated risk factors for post-transplant lymphoproliferative disease in pediatric liver transplant recipients.

Autor: Quintero Bernabeu J; Pediatric Hepatology and Liver Transplant Unit, Vall d'Hebron University Hospital, Barcelona, Spain., Juamperez J; Pediatric Hepatology and Liver Transplant Unit, Vall d'Hebron University Hospital, Barcelona, Spain., Mercadal-Hally M; Pediatric Hepatology and Liver Transplant Unit, Vall d'Hebron University Hospital, Barcelona, Spain., Larrarte King M; Pediatric Hepatology and Liver Transplant Unit, Vall d'Hebron University Hospital, Barcelona, Spain., Gallego Melcon S; Pediatric Oncology and Hematology Department, Vall d'Hebron University Hospital, Barcelona, Spain., Gros Subias L; Pediatric Oncology and Hematology Department, Vall d'Hebron University Hospital, Barcelona, Spain., Sábado Álvarez C; Pediatric Oncology and Hematology Department, Vall d'Hebron University Hospital, Barcelona, Spain., Soler-Palacin P; Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron University Hospital, Barcelona, Spain., Melendo Pérez S; Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron University Hospital, Barcelona, Spain., Esperalba J; Microbiology Department, Vall d'Hebron University Hospital, Barcelona, Spain., Navarro Jiménez A; Histology Department, Vall d'Hebron University Hospital, Barcelona, Spain., Garrido Pontnou M; Histology Department, Vall d'Hebron University Hospital, Barcelona, Spain., Camacho Soriano J; Histology Department, Vall d'Hebron University Hospital, Barcelona, Spain., Hidalgo Llompart E; HPB Surgery and Transplantation Department, Vall d'Hebron University Hospital, Barcelona, Spain., Bilbao Aguirre I; HPB Surgery and Transplantation Department, Vall d'Hebron University Hospital, Barcelona, Spain., Charco Torra R; HPB Surgery and Transplantation Department, Vall d'Hebron University Hospital, Barcelona, Spain.
Jazyk: angličtina
Zdroj: Pediatric transplantation [Pediatr Transplant] 2022 Sep; Vol. 26 (6), pp. e14292. Date of Electronic Publication: 2022 Apr 24.
DOI: 10.1111/petr.14292
Abstrakt: Background: Post-transplant lymphoproliferative disorder (PTLD) are the most common de novo malignancies after liver transplantation (LT) in children. The aim of our study was to assess the role of pre-LT EBV status and post-LT EBV viral load as risk factors for developing PTLD in a cohort of pediatric LT recipients.
Methods: Data of all children who underwent LT between January 2002 and December 2019 were collected. Two cohorts were built EBV pre-LT primary infected cohort and EBV post-LT primary infected cohort. Moreover, using the maximal EBV viral load, a ROC curve was constructed to find a cutoff point for the diagnosis of PTLD.
Results: Among the 251 patients included in the study, fifteen PTLD episodes in 14 LT recipients were detected (2 plasmacytic hyperplasia, 10 polymorphic PTLD, 2 monomorphic PTLD, and 1 Classical-Hodgkin's lymphoma). Patients of the EBV post-LT primary infected cohort were 17.1 times more likely to develop a PTLD than patients of the EBV pre-LT primary infected cohort (2.2-133.5). The EBV viral load value to predict PTLD was set at 211 000 UI/mL (93.3% sensitivity and 77.1% specificity; AUC 93.8%; IC 0.89-0.98). In EBV post-LT primary infected cohort, patients with a viral load above 211 000 were 30 times more likely to develop PTLD than patients with a viral load below this value (OR 29.8; 3.7-241.1; p < 0.001).
Conclusions: The combination of pretransplant EBV serological status with EBV post-transplant viral load could be a powerful tool to stratify the risk of PTLD in pediatric LT patients.
(© 2022 Wiley Periodicals LLC.)
Databáze: MEDLINE
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