Incidence and outcome of primary Epstein-Barr virus infection and lymphoproliferative disease in pediatric heart transplant recipients

S. D. Zangwill, Daphne T. Hsu, M. R. Kichuk, J. H. Garvin, C. J H Stolar, Jr Haddad J., S. Stylianos, Robert E. Michler, A. Chadburn, D. M. Knowles, L. J. Addonizio

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Abstract

Background: The objective of this study was to assess the relationship between Epstein-Barr virus (EBV) infection and posttransplantation lymphoproliferative disease (PTLD) in pediatric heart transplant recipients. EBV is implicated in the development of PTLD. However, the relationship between primary EBV infection and PTLD is not well understood. Methods: Serial EBV titers were determined prospectively in 50 children before and after heart transplantation. Results were correlated with the development of PTLD. The clinical presentation, management, and outcome of PTLD were characterized. Results: Before transplantation, EBV titers were positive in 19 and negative in 31 patients. After transplantation, all EBV-positive patients remained positive; 1 developed PTLD. Among EBV-negative patients, 12 of 31 remained negative; none developed PTLD. Nineteen patients demonstrated serologic evidence of primary EBV infection after heart transplantation; 12 developed PTLD. Mean follow-up after heart transplantation was 3.3 years (range 0.4 to 8.4 years). Mean time from heart transplantation to histologic confirmation of PTLD was 29 months (range 3 to 72 months). Survival with PTLD was 92% Conclusions: Twelve of 13 pediatric heart transplant recipients who developed PTLD had evidence of primary EBV infection. Serial monitoring of EBV titers may lead to earlier identification and improved treatment of PTLD.

Original languageEnglish (US)
Pages (from-to)1161-1166
Number of pages6
JournalJournal of Heart and Lung Transplantation
Volume17
Issue number12
StatePublished - 1998
Externally publishedYes

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Epstein-Barr Virus Infections
Pediatrics
Incidence
Human Herpesvirus 4
Heart Transplantation
Viral Load
Transplant Recipients
Transplantation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Transplantation

Cite this

Zangwill, S. D., Hsu, D. T., Kichuk, M. R., Garvin, J. H., Stolar, C. J. H., Haddad J., J., ... Addonizio, L. J. (1998). Incidence and outcome of primary Epstein-Barr virus infection and lymphoproliferative disease in pediatric heart transplant recipients. Journal of Heart and Lung Transplantation, 17(12), 1161-1166.

Incidence and outcome of primary Epstein-Barr virus infection and lymphoproliferative disease in pediatric heart transplant recipients. / Zangwill, S. D.; Hsu, Daphne T.; Kichuk, M. R.; Garvin, J. H.; Stolar, C. J H; Haddad J., Jr; Stylianos, S.; Michler, Robert E.; Chadburn, A.; Knowles, D. M.; Addonizio, L. J.

In: Journal of Heart and Lung Transplantation, Vol. 17, No. 12, 1998, p. 1161-1166.

Research output: Contribution to journalArticle

Zangwill, SD, Hsu, DT, Kichuk, MR, Garvin, JH, Stolar, CJH, Haddad J., J, Stylianos, S, Michler, RE, Chadburn, A, Knowles, DM & Addonizio, LJ 1998, 'Incidence and outcome of primary Epstein-Barr virus infection and lymphoproliferative disease in pediatric heart transplant recipients', Journal of Heart and Lung Transplantation, vol. 17, no. 12, pp. 1161-1166.
Zangwill, S. D. ; Hsu, Daphne T. ; Kichuk, M. R. ; Garvin, J. H. ; Stolar, C. J H ; Haddad J., Jr ; Stylianos, S. ; Michler, Robert E. ; Chadburn, A. ; Knowles, D. M. ; Addonizio, L. J. / Incidence and outcome of primary Epstein-Barr virus infection and lymphoproliferative disease in pediatric heart transplant recipients. In: Journal of Heart and Lung Transplantation. 1998 ; Vol. 17, No. 12. pp. 1161-1166.
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AU - Garvin, J. H.

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AU - Addonizio, L. J.

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