Prospective longitudinal analysis of quantitative Epstein-Barr virus polymerase chain reaction in pediatric liver transplant recipients

Background. Posttransplant lymphoproliferative disease (PTLD) remains a sig nificant cause of morbidity and mortality in pediatric liver transplant rec ipients. Epstein-Barr Virus (EBV) mismatch associated with more prevalent u se of split-liver, reduced size, and living-related transplants has increas ed the risk of primary EBV infection and subsequent PTLD, Early identificat ion of EBV viremia may reduce the risk of PTLD, because it allows for early adjustment of immunosuppression and antiviral therapy. Methods. EBV viral load was measured monthly by quantitative competitive po lymerase chain reactions in three pediatric liver transplant recipients. Results, Onset of EBV viremia was documented in one recipient. Established EBV viremia was followed in the other two recipients (one with chronic reje ction and one with PTLD) who were initially tested once monitoring was init iated in our program. Conclusions. EBV quantitative competitive polymerase chain reactions may re present a promising way to follow EBV viral load and potentially prevent th e development of PTLD.