POSTTRANSPLANT LYMPHOPROLIFERATIVE DISEASE IN PRIMARY EPSTEIN-BARR-VIRUS INFECTION AFTER LIVER-TRANSPLANTATION - THE ROLE OF CYTOMEGALOVIRUS DISEASE

Epstein-Barr virus (EBV) plays a major role in the pathogenesis of pos ttransplant lymphoproliferative disease (PTLD). Patients who undergo p rimary EBV infection after transplantation are at greater risk of deve loping PTLD. Zn this retrospective study, the incidence of EBV infecti on and associated PTLD in 40 consecutive adult recipients who were ser onegative for EBV at the time of liver transplantation were investigat ed, and risk factors for PTLD were analyzed. Of 37 patients with avail able timely posttransplant serum samples, 35 (95%) developed primary E BV infection, Of the 40 patients, 13 (33%) developed PTLD a median of 126 days (range, 48-776) after Liver transplantation. The factor signi ficantly associated with the development of PTLD was cytomegalovirus d isease (relative risk, 7.3; 95% confidence interval, 2.36-22.6; P = .0 006). Cytomegalovirus disease is a predictor fur the development of PT LD in primary EBV infection after liver transplantation, and it may be a target for prophylactic intervention.