Management and Incidence of EBV Infection in Children after Liver Transplantation Treated With Tacrolimus

Posttransplant lymphoproliferative disorder (PTLD) causes significant morbidity and mortality in pediatric liver transplantation recipients. Objective: To describe the management and outcome of patient with EBV infection diagnosed using quantitative competitive polymerase chain reaction. Materials and Methods: Retrospective descriptive study of 80 pediatric liver transplantations performed between 2009 and 2012 at the Hospital de Pediatría Prof. “Dr. Juan P. Garrahan” in Argentina. Median time of follow-up was 21.5 months (r: 3.6 to 40). Results: 38.7% (31/80) of patients developed EBV infection. The rate of acute rejection in patients with EBV infection was 64.5% (20/31). Four patients (4.3%) developed PTLD and were treated with rituximab. In this series, overall patient survival was 96%. One death was related to PTLD (1/4). Conclusion: Viral load monitoring and preventive immunomodulation are safe and effective management strategy patients with EBV infection. Children under two years of age, EBV-naive recipients, and those who develop more rejection episodes are at risk of PTLD.