Detection of Epstein-Barr virus DNAemia after lung transplantation and its potential relationship with the development of post-transplant complications. [artículo]
Por: Sequeira Lopes Da Silva, José Tiago [Medicina Interna]
| López Medrano, Francisco [Enfermedades Infecciosas] | Alonso Moralejo, Rodrigo [Neumología] | Fernández Ruiz, Mario [Medicina Interna] | Pablo Gafas, Alicia de [Neumología] | Pérez González, Virginia [Neumología] | San Juan Garrido, Rafael [Medicina Interna] | Pérez-Jacoiste Asín, María Asunción [Medicina Interna] | Ruiz Merlo, Tamara [Enfermedades Infecciosas] | Folgueira López, María Dolores [Microbiología y Parasitología] | Aguado García, José María [Enfermedades Infecciosas].
Colaborador(es): Servicio de Medicina Interna | Servicio de Neumología | Servicio de Microbiología y Parasitología | Instituto de Investigación imas12.
Tipo de material: 
ArtículoEditor: Transplant infectious disease : an official journal of the Transplantation Society, 2016Descripción: 18(3):431-41.Recursos en línea: Solicitar documento Resumen: Background: Recent studies suggest that Epstein-Barr virus DNAemia (EBVd) may act as a surrogate marker of post-transplant immunosuppression. This hypothesis has not been tested so far in lung transplant (LT) recipients.
Methods: We included 63 patients undergoing lung transplantation at our center between October 2008 and May 2013. Whole blood EBVd was systematically assessed by real-time polymerase chain reaction assay on a quarterly basis. The occurrence of late complications (overall and opportunistic infection [OI] and chronic lung allograft dysfunction [CLAD]) was analyzed according to the detection of EBVd within the first 6 months post transplantation.
Results: Any EBVd was detected in 30 (47.6%) patients. Peak EBVd was higher in patients with late overall infection (2.23 vs. 1.73 log10 copies/mL; P = 0.026) and late OI (2.39 vs. 1.74 log10 copies/mL; P = 0.004). The areas under receiver operating characteristic curves for predicting both events were 0.806 and 0.871 respectively. The presence of an EBVd ≥2 log10 copies/mL during the first 6 months post transplantation was associated with a higher risk of late OI (adjusted hazard ratio [aHR] 7.92; 95% confidence interval [CI] 2.10-29.85; P = 0.002). Patients with detectable EBVd during the first 6 months also had lower CLAD-free survival (P = 0.035), although this association did not remain statistically significant in the multivariate analysis (aHR 1.26; 95% CI 0.87-5.29; P = 0.099).
Conclusions: Although preliminary in nature, our results suggest that the detection of EBVd within the first 6 months after transplantation is associated with the subsequent occurrence of late OI in LT recipients.
| Tipo de ítem | Ubicación actual | Signatura | Estado | Fecha de vencimiento |
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Artículo
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Formato Vancouver:
Silva JT, López Medrano F, Alonso Moralejo R, Fernández Ruiz M, de Pablo Gafas A, Pérez González V et al. Detection of Epstein-Barr virus DNAemia after lung transplantation and its potential relationship with the development of post-transplant complications. Transpl Infect Dis. 2016 Jun;18(3):431-41.
PMID: 27061510
Contiene 38 referencias
Background: Recent studies suggest that Epstein-Barr virus DNAemia (EBVd) may act as a surrogate marker of post-transplant immunosuppression. This hypothesis has not been tested so far in lung transplant (LT) recipients.
Methods: We included 63 patients undergoing lung transplantation at our center between October 2008 and May 2013. Whole blood EBVd was systematically assessed by real-time polymerase chain reaction assay on a quarterly basis. The occurrence of late complications (overall and opportunistic infection [OI] and chronic lung allograft dysfunction [CLAD]) was analyzed according to the detection of EBVd within the first 6 months post transplantation.
Results: Any EBVd was detected in 30 (47.6%) patients. Peak EBVd was higher in patients with late overall infection (2.23 vs. 1.73 log10 copies/mL; P = 0.026) and late OI (2.39 vs. 1.74 log10 copies/mL; P = 0.004). The areas under receiver operating characteristic curves for predicting both events were 0.806 and 0.871 respectively. The presence of an EBVd ≥2 log10 copies/mL during the first 6 months post transplantation was associated with a higher risk of late OI (adjusted hazard ratio [aHR] 7.92; 95% confidence interval [CI] 2.10-29.85; P = 0.002). Patients with detectable EBVd during the first 6 months also had lower CLAD-free survival (P = 0.035), although this association did not remain statistically significant in the multivariate analysis (aHR 1.26; 95% CI 0.87-5.29; P = 0.099).
Conclusions: Although preliminary in nature, our results suggest that the detection of EBVd within the first 6 months after transplantation is associated with the subsequent occurrence of late OI in LT recipients.
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