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Impact of EBV infection and immune function assay for lymphoproliferative disorder in pediatric patients after liver transplantation: A single-center experience
- Source :
- Hepatobiliarypancreatic diseases international : HBPD INT. 19(1)
- Publication Year :
- 2019
-
Abstract
- Post-transplant lymphoproliferative disorder (PTLD) is a lethal complication after pediatric liver transplantation, but information regarding risk factors for the development of PTLD remains unclear. This study was to identify characteristics and risk factors of PTLD.A total of 705 pediatric patients who underwent liver transplantation between January 2017 and October 2018 were studied. Impact of clinical characteristics and Epstein-Barr virus (EBV) infection on the development of PTLD was evaluated. In addition, ImmuKnow assay was adopted in partial patients to analyze the immune status.Twenty-five (3.5%) patients suffered from PLTD with a median time of 6 months (3-14 months) after transplantation. Extremely high tacrolimus (TAC) level was found in 2 fatal cases at PTLD onset. EBV infection was found in 468 (66.4%) patients. A higher peak EBV DNA loads (9590 copies/mL) within 3 months was a significant indicator for the onset of PTLD. In addition, the ImmuKnow assay demonstrated that overall immune response was significantly lower in patients with EBV infection and PTLD (P0.0001). The cumulative incidence of PTLD was also higher in patients with lower ATP value (≤187 ng/mL, P0.05).A careful monitoring of EBV DNA loads and tacrolimus concentration might be supportive in prevention of PTLD in pediatric patients after liver transplantation. In addition, application of the ImmuKnow assay may provide guidance in reducing immunosuppressive agents in treatment of PTLD.
- Subjects :
- Male
medicine.medical_specialty
Epstein-Barr Virus Infections
Adolescent
medicine.medical_treatment
Liver transplantation
medicine.disease_cause
Single Center
Gastroenterology
Post-transplant lymphoproliferative disorder
03 medical and health sciences
0302 clinical medicine
Immune system
Adenosine Triphosphate
hemic and lymphatic diseases
Internal medicine
medicine
Humans
Child
Proportional Hazards Models
Hepatology
business.industry
Infant
Viral Load
medicine.disease
Epstein–Barr virus
Tacrolimus
Lymphoproliferative Disorders
Liver Transplantation
Transplantation
surgical procedures, operative
030220 oncology & carcinogenesis
Child, Preschool
DNA, Viral
030211 gastroenterology & hepatology
Female
Complication
business
Subjects
Details
- ISSN :
- 14993872
- Volume :
- 19
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Hepatobiliarypancreatic diseases international : HBPD INT
- Accession number :
- edsair.doi.dedup.....a96fca98c306322a6873bcc741c1ac96