Response of elevated Epstein-Barr virus DNA levels to therapeutic changes in pediatric liver transplant patients: 56-month follow up and outcome

Holmes, Richard D.; Orban-Eller, Kathy; Karrer, F.; Rowe, David; Narkewicz, Michael R.; Sokol, Ronald J.

doi:10.1097/00007890-200208150-00013

Cited by 57 publications

(43 citation statements)

References 22 publications

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“…Measuring EBV DNA has since been studied extensively and is now an indispensable tool for controlling PTLD. This method is used not only for diagnosis, but also for disease prediction [33,34,[58][59][60], therapeutic efficacy estimation [61,62], and prevention [63][64][65][66]. There has been debate regarding which specimen(s) should be used to identify PTLD.…”

Section: Post-transplant Lymphoproliferative Disordermentioning

confidence: 99%

Measuring Epstein–Barr virus (EBV) load: the significance and application for each EBV‐associated disease

Kimura

Ito

Suzuki

et al. 2008

Reviews in Medical Virology

137

142

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Because Epstein-Barr virus (EBV) is ubiquitous and persists latently in lymphocytes, simply detecting EBV is insufficient to diagnose EBV-associated diseases. Therefore, measuring the EBV load is necessary to diagnose EBVassociated diseases and to explore EBV pathogenesis. Due to the diverse biology of EBV, the significance of measuring EBV DNA and the optimal type of specimen differ among EBV-associated diseases. Recent advances in molecular technology have enabled the EBV genome to be quantitated rapidly and accurately. Real-time polymerase chain reaction (PCR) is a rapid and reliable method to quantify DNA and is widely used not only as a diagnostic tool, but also as a management tool for EBV-associated diseases. However, each laboratory currently measures EBV load with its own ''homebrew'' system, and there is no consensus on sample type, sample preparation protocol, or assay units. The EBV real-time PCR assay system must be standardised for large-scale studies and international comparisons.

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Section: Post-transplant Lymphoproliferative Disordermentioning

confidence: 99%

Measuring Epstein–Barr virus (EBV) load: the significance and application for each EBV‐associated disease

Kimura

Ito

Suzuki

et al. 2008

Reviews in Medical Virology

137

142

View full text Add to dashboard Cite

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“…The dose of the immunosuppressive treatment was reduced in these patients and oral valganciclovir treatment was administrated as an antiviral therapy. After this treatment, 9 patients became EBV-negative and 5 patients (8%) became chronic EBV patients [5,6]. Only one of these patients developed PTLD.…”

Section: Infectionmentioning

confidence: 99%

Pediatric Liver Transplantation: Our Experiences

Baştürk

Yılmaz

Sayar³

et al. 2017

Eurasian J Med

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Objective: The aim of our study was to evaluate our liver transplant pediatric patients and to report our experience in the complications and the long-term follow-up results. Materials and Methods:Patients between the ages of 0 and 18 years, who had liver transplantation in the organ transplantation center of our university hospital between 1997 and 2016, were included in the study. The age, sex, indications for the liver transplantation, complications after the transplantation, and long-term follow-up findings were retrospectively evaluated. The obtained results were analyzed with statistical methods.Results: In our organ transplantation center, 62 pediatric liver transplantations were carried out since 1997. The mean age of our patients was 7.3 years (6.5 months-17 years). The 4 most common reasons for liver transplantation were: Wilson's disease (n=10; 16.3%), biliary atresia (n=9; 14.5%), progressive familial intrahepatic cholestasis (n=8; 12.9%), and cryptogenic cirrhosis (n=7; 11.3%). The mortality rate after transplantation was 19.6% (12 of the total 62 patients). The observed acute and chronic rejection rates were 34% and 4.9%, respectively. Thrombosis (9.6%) was observed in the hepatic artery (4.8%) and portal vein (4.8%). Bile leakage and biliary stricture rates were 31% and 11%, respectively. 1-year and 5-year survival rates of our patients were 87% and 84%, respectively. Conclusion:The morbidity and mortality rates in our organ transplantation center, regarding pediatric liver transplantations, are consistent with the literature.Keywords: Child, liver transplantation, liver failure ÖZ Amaç: Çalışmamızın amacı pediatrik karaciğer nakilli hastalarımızı değerlendirerek deneyim, komplikasyonlar ve uzun süreli izlem sonuçlarımızı bildirmektir.Gereç ve Yöntem: Üniversite hastanesi organ nakil merkezinde 1997 ile 2016 yılları arasında karaciğer nakli yapılmış 0-18 yaş arasındaki hastalar ile çalışma yapılmıştır. Hastaların yaş, cinsiyet, karaciğer nakil endikasyonu, nakil sonrası komplikasyonlar ve uzun süreli izlem bulguları retrospektif olarak değerlendi-rilmiştir. Elde edilen sonuçların istatistiksel analizi yapılmıştır.Bulgular: 1997'den bu yana organ nakli ünitemizde toplam 62 çocuk hastaya karaciğer nakili yapılmıştır. Ortalama yaş 7,3 yıl saptandı (6,5 ay-17 yaş). Karaciğer nakil endikasyonlarının en sık 4 nedenini sırasıyla Wilson hastalığı %16,3 (10 hasta), bilier atrezi %14,5 (9 hasta), progressif familyal intrahepatik kolestaz %12,9 (8 hasta), kriptojenik siroz %11,3 (7 hasta), oluşturuyordu. Nakil sonrası mortalitemiz %19,6 oranında idi (toplam 62 hastanın 12'de). Akut rejeksiyon %34 oranında, kronik rejeksiyon ise %4,9 oranında gözlenmiştir. Tromboz %9,6 oranında gözlenmiş olup % 4,8 oranında hepatik arterde ve %4,8 oranında portal vende gözlendi. Bilier sızıntı %31 oranında gözlenmiş olup bilier darlık ise %11 oranında gözlen-miştir. Hastalarımızın 1 yıllık sağ kalımı %87 ve 5 yıllık sağ kalımı %84 saptanmıştır.Sonuç: Organ nakli merkezimizin, çocukluk döneminde yaptığı karaciğer nakil...

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“…Antiviral therapy with ganciclovir and CMV-IgG is also used in most cases, although only nonrandomized observational studies support their use. Treatment should be continued until symptoms such as lymphadenopathy have resolved and the viral EBV-DNA PCR level has returned to baseline [74,75]. Posttransplantation lymphoproliferative disease (PTLD) can develop and progress without an increase in EBV-PCR viral load [76].…”

Section: Infectionmentioning

confidence: 99%

“…Documented PTLD requires an immediate decrease in or discontinuation of immunosuppression and institution of anti-EBV therapy. Patients who have polyclonal B-cell proliferation frequently show regression with this treatment [74,75]. If tumor cells express the B-cell marker CD20 at histology, the anti-CD20 monoclonal antibody rituximab has been used with increasing success.…”

Section: Infectionmentioning

confidence: 99%