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Epstein-Barr viral load before a liver transplant in children with chronic liver disease
Nader Shakibazad1, Naser Honar, Seyed Mohsen Dehghani
1From the Department of Pediatrics, Shiraz University of Medical Sciences, School of Medicine, Nemazee Teaching Hospital, Shiraz, Iran.
Insights
High Epstein-Barr viral load in children awaiting liver transplants may indicate a risk for posttransplant lymphoproliferative disorder. Measuring viral load before transplant is crucial for risk assessment in pediatric liver disease patients.
Area of Science:
- Pediatric Hepatology
- Transplant Immunology
- Virology
Background:
- Children with chronic liver disease often need liver transplants.
- These patients face increased infection risks, including Epstein-Barr virus (EBV).
- Pre-transplant EBV status is critical for managing post-transplant complications.
Purpose of the Study:
- To quantify Epstein-Barr viral load in pediatric liver transplant candidates.
- To assess the prevalence of EBV infection before liver transplantation.
- To identify potential risk factors for post-transplant complications.
Main Methods:
- Cross-sectional study conducted at Shiraz University of Medical Sciences.
- Included pediatric patients (<18 years) awaiting liver transplant.
- Measured Epstein-Barr viral load using real-time TaqMan polymerase chain reaction.
Main Results:
- Ninety-eight pediatric patients were analyzed (mean age 6.5 years).
- Cryptogenic cirrhosis was the primary indication for transplant.
- Six patients (6.1%) had detectable EBV viral load; 4 (4.1%) had high loads (>1000 copies/mL).
Conclusions:
- High pre-transplant Epstein-Barr viral load is a potential risk factor.
- A significant prevalence of high EBV viral load was observed in this cohort.
- This finding suggests EBV screening is important for pediatric liver transplant recipients to predict post-transplant lymphoproliferative disorder.
Objectives:
Many children with chronic liver disease require a liver transplant. These patients are prone to various infections, including Epstein-Barr virus infection. This study sought to measure the Epstein-Barr viral load by polymerase chain reaction before a liver transplant.
Materials And Methods:
This cross-sectional study was done at the Shiraz University of Medical Sciences, Shiraz, Iran, in 2011. All patients were aged younger than 18 years with chronic liver disease and were candidates for a liver transplant at the Shiraz Nemazee Hospital Organ Transplant Center. They had been investigated regarding their demographic characteristics, underlying disease, laboratory findings, and Epstein-Barr viral load by real-time TaqMan polymerase chain reaction.
Results:
Ninety-eight patients were studied and the mean age was 6.5 ± 5.9 years. Cryptogenic cirrhosis was the most-prevalent reason for liver transplant, and the death rate before a transplant was 15%. Among the study subjects, 6 had measurable Epstein-Barr viral load by polymerase chain reaction before the transplant, and 4 of them had considerably higher Epstein-Barr viral loads (more than 1000 copies/mL).
Conclusions:
With respect to the close prevalence of posttransplant lymphoproliferative disease (6%) and the high Epstein-Barr viral load in the patients before a transplant (4%), high pretransplant Epstein-Barr viral load can be considered a risk factor for posttransplant lymphoproliferative disorder.
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