Relevance of EBV load monitoring in renal transplant recipients; a retrospective cohort study

L. Gard, C. Oliveira dos Santos, W. van Doesum, H.G.M. Niesters, W.J. van Son, A. Diepstra, C.A. Stegeman, H. Groen, J.S.F. Sanders, A. Riezebos-Brilman

Friday 16 march 2018

10:20 - 10:25h at Willem Burger Foyer

Categories: Clinical, Session (poster)

Parallel session: Poster session 7: Clinical

Background

Currently, EBV load monitoring after transplantation is used to predict post-transplant lymphoproliferative disorder (PTLD) development in high risk populations. The incidence of PTLD in renal transplant recipients is relatively low compared to other solid organ transplantations, whereby the implications of EBV viremia after renal transplantation are not clear. We studied in a retrospective single center cohort the additive value of EBV monitoring on outcome parameters in renal transplant recipients (RTR).

Methods

In total 373 RTR were included who received a kidney transplant between 2010 and 2012. The incidence of EBV viremia in whole blood and the outcome in eGFR, BPAR, graft loss and patient survival was studied.

Results

Of the 373 RTR, 121 recipients were EBV DNA negative (32.4%), whereas EBV DNA was detectable at least once in 252 recipients (67.5%). In this cohort one EBV seronegative patient developed histological proven PTLD (0.4%). Incidence of graft failure was not significantly different between the EBV viremia group (n=25/247,10.1%) and the EBV viremia negative group (n=7/121, 5.8%) (RR= 1.75, 95% CI 0.8-3.9, p=0.17). The longitudinal course of eGFR was significantly lower in the group with EBV viremia, after 48 months (p= 0.037). Biopsy proven acute rejection (BPAR) and mortality rate did not differ between the groups with or without EBV viremia.

Conclusion

In conclusion, this study demonstrated that EBV viremia is common in RTR, patients with EBV viremia had a significantly lower eGFR, however, no association with BPAR, graft loss, and patient survival was found.