THE significant concern of Epstein-Barr virus (EBV) in pediatric liver transplant recipients due to its strong association with post-transplant lymphoproliferative disorder (PTLD) has been explored in a recently published study. PTLD is one of the most common malignancies following liver transplantation, leading to considerable morbidity and mortality among affected children.
Several factors influence the risk of developing PTLD, including EBV-serostatus mismatch and prolonged or high levels of immunosuppression. These factors necessitate vigilant pre-transplant EBV serological screening and post-transplant monitoring of EBV-DNA levels. Despite these recommendations, universal guidelines for the prevention and management of PTLD remain elusive, leading to varied clinical practices.
Current treatment strategies for PTLD typically involve reducing immunosuppression and employing targeted therapies such as rituximab. In cases where PTLD is refractory, chemotherapy may be necessary. This review highlights the importance of understanding EBV’s relationship with PTLD, evaluating available treatment modalities, and exploring evolving strategies for using EBV as a biomarker for PTLD screening and prevention.
The lack of robust prospective studies underscores the need for standardized guidelines to improve patient outcomes.
Reference: Chen EY et al. Navigating Epstein-Barr Virus (EBV) and Post-Transplant Lymphoproliferative Disorder (PTLD) in Pediatric Liver Transplantation: Current Knowledge and Strategies for Treatment and Surveillance. Viruses. 2025;17(2):254.
Anaya Malik | AMJ
