Das B, Morrow R, Huang R, Fixler D. Persistent Epstein-Barr viral load in Epstein-Barr viral naïve pediatric heart transplant recipients: Risk of late-onset post-transplant lymphoproliferative disease. World J Transplant 2016; 6(4): 729-735 [PMID: 28058224 DOI: 10.5500/wjt.v6.i4.729]
Corresponding Author of This Article
Bibhuti Das, MD, Deptartment of Pediatrics, Children’s Medical Center, University of Texas Southwestern Medical Center, 1935 Medical District Dr, Dallas, TX 75235, United States. bdas99@hotmail.com
Research Domain of This Article
Transplantation
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Dec 24, 2016; 6(4): 729-735 Published online Dec 24, 2016. doi: 10.5500/wjt.v6.i4.729
Persistent Epstein-Barr viral load in Epstein-Barr viral naïve pediatric heart transplant recipients: Risk of late-onset post-transplant lymphoproliferative disease
Bibhuti Das, Robert Morrow, Rong Huang, David Fixler
Bibhuti Das, David Fixler, Deptartment of Pediatrics, Children’s Medical Center, University of Texas Southwestern Medical Center, Dallas, TX 75235, United States
Robert Morrow, Rong Huang, Children’s Medical Center, Dallas, TX 75235, United States
Author contributions: All the authors contributed to the manuscript.
Institutional review board statement: University of Texas Southwestern Medical center and Children’s Medical Center, Dallas Institutional Review Board approved this study.
Informed consent statement: Patients were not required to give informed consent because of observational, retrospective nature of the study.
Conflict-of-interest statement: The authors of this manuscript have no conflicts of interest to disclose pertinent to this research.
Data sharing statement: No additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Bibhuti Das, MD, Deptartment of Pediatrics, Children’s Medical Center, University of Texas Southwestern Medical Center, 1935 Medical District Dr, Dallas, TX 75235, United States. bdas99@hotmail.com
Telephone: +1-214-4566333 Fax: +1-214-4567758
Received: July 7, 2016 Peer-review started: July 12, 2016 First decision: September 12, 2016 Revised: October 5, 2016 Accepted: November 21, 2016 Article in press: November 23, 2016 Published online: December 24, 2016 Processing time: 161 Days and 10.4 Hours
Core Tip
Core tip: Post-transplant lymphoproliferative disorder (PTLD) after heart transplantation is a severe complication where there is still limited information is available. There are many publications on estimations of PTLD frequency in different settings and types of patient, as well as the factors associated with its appearance and prognosis. But, most studies do not take into account the length of follow-up which may be misleading given that patients are exposed to the risk of immunosuppression over a long period of follow-up. This study is unique that, it is a single center study span over a period of 18 years in which maintenance immunosuppression therapy and management of rejection episodes remained same throughout. Although, a single center study result cannot be generalized, however it adds to the existing literature for risk stratification of these patients based on whole blood Epstein-Barr virus (EBV) polymerase chain reaction (PCR) after accounting for the time since transplant and patients¡¯ pre-transplant EBV serostatus. This paper also highlights the risk of acute rejection after reduction or alteration in immunosuppression in patients with high EBV load by PCR without any effect on the occurrence of PTLD.
