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Epstein-Barr virus hepatitis after liver transplantation
A N Langnas1, R S Markin, M Inagaki
1Department of Surgery, University of Nebraska Medical Center, Omaha.
The American Journal of Gastroenterology
|July 1, 1994
Summary
Epstein-Barr virus (EBV) hepatitis is rare after liver transplants but treatable. Antilymphocyte therapy increases the risk of developing this complication, highlighting the need for careful patient monitoring.
Area of Science:
- Hepatology
- Virology
- Transplantation Immunology
Background:
- Epstein-Barr virus (EBV) can cause hepatitis post-liver transplantation.
- Risk factors and outcomes require further investigation.
Purpose of the Study:
- To review the clinical experience with EBV hepatitis following liver transplantation.
- To identify risk factors associated with EBV hepatitis development.
Main Methods:
- Retrospective review of 668 liver transplants over 68 months.
- Diagnosis confirmed by allograft biopsy and polymerase chain reaction (PCR).
- Analysis of antilymphocyte therapy use in 585 patients.
Main Results:
- 11 patients (2%) developed EBV hepatitis, with a median diagnosis time of 45 days post-transplant.
- One-year survival was 73%; risk factors included multiple antilymphocyte courses or high OKT3 dose.
- Treatment involved reduced immunosuppression, antiviral therapy, and IVIG.
Conclusions:
- EBV hepatitis is an infrequent but manageable complication of liver transplantation.
- Antilymphocyte preparations are strongly associated with increased EBV hepatitis risk.