Document Detail


Screening for PTLD in lung and heart-lung transplant recipients by measuring EBV DNA load in bronchoalveolar lavage fluid using real time PCR.
MedLine Citation:
PMID:  18466434     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pediatric L-HLTx recipients are at risk for developing PTLD with the lung being a primary site of disease. We hypothesized that BALF is a better sample than peripheral blood for measuring EBV DNA load in this high-risk population. Archived BALF specimens from pediatric L-HLTx recipients with and without PTLD were assayed for EBV DNA load using a quantitative real time TaqMan PCR assay. These values were compared with values determined in peripheral blood by a competitive PCR assay. Fifty-five BALF specimens from 16 L-HLTx patients were evaluated. Three patients with PTLD had mean BALF EBV DNA load values almost 50-fold higher than subjects without PTLD (4.6 x 10(5) copies/mL vs. 1.0 x 10(4) copies/mL). Patients who were EBV seronegative pretransplantation (i.e., high risk for PTLD) had elevated EBV DNA load values vs. patients who were EBV seropositive pretransplantation, regardless of the diagnosis of PTLD (mean values of 3.2 x 10(5) copies/mL vs. 1.1 x 10(4) copies/mL). Lastly, BALF analysis identified all subjects with PTLD, whereas peripheral blood analysis identified only one of these cases. Therefore, it can be concluded that monitoring EBV DNA load in BALF following L-HLTx facilitates detection of PTLD in high-risk patients and may be superior to peripheral blood assays.
Authors:
Peter Michelson; Bradley Watkins; Steven A Webber; Robert Wadowsky; Marian G Michaels
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric transplantation     Volume:  12     ISSN:  1399-3046     ISO Abbreviation:  Pediatr Transplant     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-09     Completed Date:  2008-09-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9802574     Medline TA:  Pediatr Transplant     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  464-8     Citation Subset:  IM    
Affiliation:
Duke University School of Medicine, Department of Pediatrics, Durham, NC 27710, USA. peter.michelson@duke.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Bronchoalveolar Lavage Fluid / virology*
Child
Epstein-Barr Virus Infections / diagnosis*,  metabolism
Female
Heart-Lung Transplantation / adverse effects*
Herpesvirus 4, Human / metabolism*
Humans
Lung Transplantation / adverse effects*
Lymphoproliferative Disorders / diagnosis*,  etiology*
Male
Retrospective Studies
Reverse Transcriptase Polymerase Chain Reaction / methods*
Viral Load

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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