For patients undergoing liver transplant (LT), Epstein-Barr virus (EBV) viral load (VL) monitoring may reduce the incidence of posttransplant lymphoproliferative disease (PTLD), according to a study published online Jan. 17 in the Annals of Internal Medicine.
Bastian N. Ruijter, M.D., from Leiden University Medical Center in the Netherlands, and colleagues examined the effect of an EBV VL monitoring strategy on the incidence of PTLD after LT in a cohort study involving adult recipients of first LT. The monitoring group included recipients of first LT in Leiden between September 2003 and January 2017 with an EBV VL monitoring strategy; the contemporary control group included recipients of first LT in Rotterdam between January 2003 and January 2017 without such a strategy. Historical control groups included those who had transplants between September 1992 and September 2003 in Leiden and between 1986 and January 2003 in Rotterdam.
The researchers found that at five-, 10-, and 15-year follow-up, fewer PTLD events were seen in the contemporary era in both centers after inverse probability of treatment weighting of the four groups. In the monitoring center, the difference was considerably larger, while for point estimates, the 95 percent confidence interval included the null value of 0.
“We strongly believe that the reported results merit serious consideration of the EBV VL monitoring policy in an attempt to reduce the incidence of PTLD after LT in adults,” the authors write.
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Annals of Internal Medicine
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