Kidney transplantation after chronic active Epstein-Barr virus infection remission

Chronic active Epstein-Barr virus is a rare but severe condition characterized by persistent Epstein-Barr virus activation, leading to chronic lymphoproliferation, significant morbidity, and mortality. We report the case of a 34-year-old male with autosomal dominant polycystic kidney disease who achieved chronic active Epstein-Barr virus remission through hematopoietic stem cell transplantation in childhood. Despite long-term remission, the patient developed end-stage renal disease and underwent ABO-incompatible living-donor kidney transplantation. Post-transplant monitoring over 7 months revealed no major complications, including post-transplant lymphoproliferative disorder or rejection, despite transient Epstein-Barr virus-DNA positivity. This case underscores the feasibility of kidney transplantation in chronic active Epstein-Barr virus survivors with careful immunosuppressive management. It also highlights the critical need for vigilant long-term surveillance to mitigate the risks of malignancies and viral reactivation.