TY - JOUR
T1 - Epstein-Barr viral loads do not predict post-transplant lymphoproliferative disorder in pediatric lung transplant recipients
T2 - A multicenter prospective cohort study
AU - the Clinical Trials in Organ Transplantation in Children (CTOTC-03)
AU - Parrish, Andrew
AU - Fenchel, Matthew
AU - Storch, Gregory A.
AU - Buller, Richard
AU - Mason, Sheila
AU - Williams, Nikki
AU - Ikle, David
AU - Conrad, Carol
AU - Faro, Albert
AU - Goldfarb, Samuel
AU - Hayes, Don
AU - Melicoff-Portillo, Ernestina
AU - Schecter, Marc
AU - Visner, Gary
AU - Sweet, Stuart
AU - Danziger-Isakov, Lara
AU - Jiang, Dawei
AU - Kim, Rosa
AU - Nguyen, Sara
AU - Merkel, Elisabeth
AU - Astor, Todd
AU - Kirkby, Stephen
AU - Nance, Ashley
AU - Nicholson, Kerri
AU - Meyer, Susan
AU - Eisenbarger, Colleen
AU - Mallory, George
AU - Ebenbichler, Mea
N1 - Publisher Copyright:
© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2017/9
Y1 - 2017/9
N2 - Prediction of PTLD after pediatric lung transplant remains difficult. Use of EBV VL in WB has been poorly predictive, while measurement of VL in BAL fluid has been suggested to have enhanced utility. The NIH-sponsored Clinical Trials in Organ Transplantation in Children (CTOTC-03) prospectively obtained serial quantitative measurements of EBV PCR in both WB and BAL fluid after pediatric lung transplantation. Descriptive statistics, contingency analyses, and Kaplan-Meier analyses evaluated possible association between EBV and PTLD. Of 61 patients, 34 (56%) had an EBV+PCR (at least once in WB or BAL). EBV donor (D)+patients more often had a positive PCR (D+/recipient (R)−: 13/18; D+/R+: 14/23) compared to EBV D- patients (6/17). Several D−/R− (5/12) patients developed EBV, but none developed PTLD. All four PTLD patients were D+/R− with EBV+PCR. Neither the time to first EBV+PCR nor the CT for PCR positivity in BAL or WB was statistically different between those with and without PTLD. Having an EBV-seropositive donor was associated with increased risk of EBV+PCR in WB. EBV load in BAL was not predictive of PTLD.
AB - Prediction of PTLD after pediatric lung transplant remains difficult. Use of EBV VL in WB has been poorly predictive, while measurement of VL in BAL fluid has been suggested to have enhanced utility. The NIH-sponsored Clinical Trials in Organ Transplantation in Children (CTOTC-03) prospectively obtained serial quantitative measurements of EBV PCR in both WB and BAL fluid after pediatric lung transplantation. Descriptive statistics, contingency analyses, and Kaplan-Meier analyses evaluated possible association between EBV and PTLD. Of 61 patients, 34 (56%) had an EBV+PCR (at least once in WB or BAL). EBV donor (D)+patients more often had a positive PCR (D+/recipient (R)−: 13/18; D+/R+: 14/23) compared to EBV D- patients (6/17). Several D−/R− (5/12) patients developed EBV, but none developed PTLD. All four PTLD patients were D+/R− with EBV+PCR. Neither the time to first EBV+PCR nor the CT for PCR positivity in BAL or WB was statistically different between those with and without PTLD. Having an EBV-seropositive donor was associated with increased risk of EBV+PCR in WB. EBV load in BAL was not predictive of PTLD.
KW - Epstein-Barr virus
KW - bronchoalveolar lavage
KW - lung transplantation
KW - pediatrics
KW - post-transplant lymphoproliferative disorder
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UR - http://www.scopus.com/inward/citedby.url?scp=85021386582&partnerID=8YFLogxK
U2 - 10.1111/petr.13011
DO - 10.1111/petr.13011
M3 - Article
C2 - 28639398
AN - SCOPUS:85021386582
SN - 1397-3142
VL - 21
JO - Pediatric transplantation
JF - Pediatric transplantation
IS - 6
M1 - e13011
ER -