Impact of EBV infection and immune function assay for lymphoproliferative disorder in pediatric patients after liver transplantation: A single-center experience

Qin, Tian; Gu, Xiang; Jeong, Seogsong; Song, Yan; Liu, Jin Chuan; Zheng, Jian Xin; Xue, Feng; Xia, Qiang

doi:10.1016/j.hbpd.2019.12.005

Cited by 10 publications

(9 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…9 Derived from experience in hematopoietic stem cell transplant and taking into account that PCR-based EBV monitoring techniques are currently available in most SOT centers, there is a great interest in EBV surveillance and prevention of PTLD in SOT recipients. 5,11,13,26 In our population, viral load was statistically significantly higher in PTLD patients than in non-PTLD patients. In an attempt to stratify the risk of our patients, a ROC curve was calculated in order to define the cutoff point that best differentiated patients at risk of developing PTLD.…”

Section: Discussionmentioning

confidence: 56%

“…EBV‐VL monitoring has been used to prevent and diagnose PTLD in hematopoietic stem cell transplant recipients 9 . Derived from experience in hematopoietic stem cell transplant and taking into account that PCR‐based EBV monitoring techniques are currently available in most SOT centers, there is a great interest in EBV surveillance and prevention of PTLD in SOT recipients 5,11,13,26 . In our population, viral load was statistically significantly higher in PTLD patients than in non‐PTLD patients.…”

Section: Discussionmentioning

confidence: 92%

“…However, it can help us to indicate that patients with higher viral loads (around 200 000-250 000 UI/mL) could have a higher risk of suffering from the disease. Other singlecenter studies have determined different viral load thresholds as PTLD predictor 11,26,27. Nevertheless, it is very difficult to compare studies, as the EBV DNA load monitoring in each medical center might be quite different in samples, methods and diagnostic values.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Epstein–Barr virus‐associated risk factors for post‐transplant lymphoproliferative disease in pediatric liver transplant recipients

Bernabeu¹,

Juampérez²,

Mercadal-Hally³

et al. 2022

Pediatric Transplantation

View full text Add to dashboard Cite

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 posttransplant viral load could be a powerful tool to stratify the risk of PTLD in pediatric LT patients.

show abstract

Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 92%

mentioning

confidence: 99%

See 1 more Smart Citation

Epstein–Barr virus‐associated risk factors for post‐transplant lymphoproliferative disease in pediatric liver transplant recipients

Bernabeu¹,

Juampérez²,

Mercadal-Hally³

et al. 2022

Pediatric Transplantation

View full text Add to dashboard Cite

show abstract

“…Increased EBV viral load with the cut-off value of 44,000 copies/mL/week was associated with an increased risk of PTLD with a sensitiv-ity of 64.3% and a specificity of 70.9% (29). Another study carried out in China also suggested that close monitoring of EBV DNA loads and checking the tacrolimus concentration might be useful in preventing the occurrence of PTLD amongst children after liver transplantation (30). Similarly, Chen et al recommended the tapering of immunosuppressants in case of high EBV viral load in children (31).…”

Section: Discussionmentioning

confidence: 94%

Post-transplant Lymphoproliferative Disorder in Pediatric Liver Transplantation: A Population-based Study from Shiraz, Iran

et al. 2021

View full text Add to dashboard Cite

Background: This study aimed to determine the prevalence of post-transplant lymphoproliferative disorder (PTLD) based on the clinical and epidemiological characteristics of donors and pediatric transplant recipients. Methods: This cross-sectional study was conducted on the patients who had experienced liver transplantation at Shiraz Transplant Center, Shiraz, Iran, from April 2007 to March 2017. Data on the epidemiological characteristics, underlying diseases, dosage of immunosuppressive drugs, and duration of drug consumption from the time of liver transplantation until the onset of PTLD for transplant recipients, and donors’ age, sex, and family relationship with recipients were collected using a data-gathering form. Log rank test was employed to determine the variations in the distribution of survival in different sex and age groups. Results: The study findings indicated that 49 out of the 1207 children who had undergone liver transplantation developed PTLD, revealing a prevalence of 4%. The results showed no significant relationship between gender and the incidence of PTLD (P = 0.13). However, the mean age of the cases with PTLD was 4.93 ± 1.07 years at the time of transplantation, while non-PTLD patients showed a higher mean age at that time (7.80 ± 5.54). The mean dose of the immunosuppressive drugs (dose/kg) consumed by the recipients was as follows: tacrolimus = 0.2753 ± 0.23435, prednisolone = 0.6761 ± 0.62218, cellcept = 0.0724 ± 0.12963, and sirolimus = 0.1078 ± 0.08813. The average consumption period of the above-mentioned drugs from the time of transplantation until the onset of PTLD was 14.7 ± 14.409 months. Based on the results, the five-year survival rate was much lower in the patients with PTLD compared to the non-PTLD patients (31% Vs. 72.7%). The survival distribution was significantly different based on sex and age groups (P = 0.59 and P = 0.06, respectively). Conclusions: The prevalence of the clinical and epidemiological features of the PTLD in the patients under the present investigation was similar to those of the patients in other hospitals. Recognizing the clinical and epidemiological characteristics of transplant recipients with and without PTLD and donors can provide a basis for managing these patients.

show abstract

“…At present, it is believed that the occurrence of PTLD is closely related to postoperative EBV infection (14). The incidence of PTLD after pLT can reach 2%-20% (15)(16)(17). In pLT, EBV serological negativity before transplantation is considered to be a major risk factor for PTLD.…”

Section: Discussionmentioning

confidence: 99%

The value of 18 F-FDG PET/CT quantitative indexes in the diagnosis of non-destructive PTLD after pediatric liver transplantation

Zhai

et al. 2022

Preprint

View full text Add to dashboard Cite

Rationale: Post-transplant lymphoproliferative disease (PTLD) is a serious complication after pediatric liver transplantation (pLT), which may lead to death. F-FDG PET/CT is rarely considered in PTLD after pLT and lacks clear diagnostic guidelines, especially in the differential diagnosis of non-destructive PTLD. The aim of this study was to find a quantifiable F-FDG PET/CT index to identify non-destructive PTLD after pLT. Materials and Methods: This retrospective study collected the data of patients who underwent pLT, postoperative lymph node biopsy, and F-FDG PET/CT at Tianjin First Central Hospital from January 2014 to December 2021. Quantitative indexes were established using lymph node morphology and the maximum standardized uptake value (SUVmax). Results: A total of 83 patients met the inclusion criteria and were included in this retrospective study. To distinguish between PTLD-negative cases and non-destructive PTLD cases, according to the receiver operating characteristic curve, [the shortest diameter of the lymph node at the biopsy site (SDL)/the longest diameter of the lymph node at the biopsy site (LDL)]*[SUVmax at the biopsy site (SUVmaxBio)/SUVmax of the tonsils (SUVmaxTon)] had the maximum area under the curve (0.923; 95% confidence interval, 0.834–1.000), and the cut-off value was 0.264 according to the maximum value of Youden’s index. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 93.6%, 94.7%, 97.8%, 85.7%, and 93.9%, respectively. Conclusions: (SDL/LDL)*(SUVmaxBio/SUVmaxTon) has good sensitivity, specificity, positive predictive and negative predictive values, and accuracy, and can be used as a good quantitative index for the diagnosis of non-destructive PTLD.

show abstract

Impact of EBV infection and immune function assay for lymphoproliferative disorder in pediatric patients after liver transplantation: A single-center experience

Cited by 10 publications

References 35 publications

Epstein–Barr virus‐associated risk factors for post‐transplant lymphoproliferative disease in pediatric liver transplant recipients

Epstein–Barr virus‐associated risk factors for post‐transplant lymphoproliferative disease in pediatric liver transplant recipients

Post-transplant Lymphoproliferative Disorder in Pediatric Liver Transplantation: A Population-based Study from Shiraz, Iran

The value of 18 F-FDG PET/CT quantitative indexes in the diagnosis of non-destructive PTLD after pediatric liver transplantation

Contact Info

Product

Resources

About