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Impact of antiviral prophylaxis in adults Epstein-Barr Virus-seronegative kidney recipients on early and late post-transplantation lymphoproliferative disorder onset: a retrospective cohort study.
Ville, Simon; Imbert-Marcille, Berthe-Marie; Coste-Burel, Marianne; Garandeau, Claire; Meurette, Aurélie; Cantarovitch, Diego; Giral, Magali; Hourmant, Maryvonne; Blancho, Gilles; Dantal, Jacques.
Affiliation
  • Ville S; Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France.
  • Imbert-Marcille BM; Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.
  • Coste-Burel M; Service de Néphrologie Immunologie-clinique, CHU Nantes, Nantes, France.
  • Garandeau C; Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France.
  • Meurette A; Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.
  • Cantarovitch D; Laboratoire de Virologie, CHU Nantes, Nantes, France.
  • Giral M; Laboratoire de Virologie, CHU Nantes, Nantes, France.
  • Hourmant M; Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France.
  • Blancho G; Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.
  • Dantal J; Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France.
Transpl Int ; 31(5): 484-494, 2018 05.
Article in En | MEDLINE | ID: mdl-29057508
ABSTRACT
Post-transplantation lymphoproliferative disorder (PTLD) pathogenesis is related to EBV infection. Mismatch with the donor (EBV D+/R-) is the main risk factor for both early PTLD (<1 year post-transplantation) and late (>1 year). In these at-risk patients, the role of antiviral prophylaxis for preventing PTLD remains controversial. We analyzed the impact of antiviral drugs given to prevent CMV disease in a monocentric retrospective cohort of 73 adult kidney or kidney-pancreas EBV-seronegative recipients, transplanted between 01/01/2000 and 01/01/2016. Thirty-seven (50.7%, prophylaxis group) received (val-)aciclovir or (val-)ganciclovir for 3-6 months and 36 (49.3%, no-prophylaxis group) received no-prophylaxis. Mean follow-up was 69 ± 7.2 months in the prophylaxis group and 91 ± 10.3 months in the no-prophylaxis group. Monitoring of EBV PCR revealed that prophylaxis delayed primary infection at 100 days (43% vs. 84%, P = 0.02). Early PTLD incidence was not different between groups (4/37 vs. 4/36, P = 0.99). Concerning late events, EBV-related neoplasia incidence was significantly lower in treated patients among whom no cases were observed, while in the no-prophylaxis group 6 cases were reported (P = 0.02). Despite a weak level of evidence our study suggests that antiviral prophylaxis could prevent late onset PTLD.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Antiviral Agents / Kidney Transplantation / Epstein-Barr Virus Infections / Lymphoproliferative Disorders Type of study: Etiology_studies / Observational_studies / Risk_factors_studies Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Transpl Int Journal subject: TRANSPLANTE Year: 2018 Document type: Article Affiliation country: France

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Antiviral Agents / Kidney Transplantation / Epstein-Barr Virus Infections / Lymphoproliferative Disorders Type of study: Etiology_studies / Observational_studies / Risk_factors_studies Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Transpl Int Journal subject: TRANSPLANTE Year: 2018 Document type: Article Affiliation country: France