Detection of Epstein–Barr virus DNA in peripheral blood is associated with the development of bronchiolitis obliterans syndrome after lung transplantation

Welte, Tobias; Fühner, Thomas; Simon, Andrè; Mattner, Frauke; Hoy, Ludwig; Schulz, Thomas F.; Gottlieb, Jens

doi:10.1016/j.jcv.2009.02.005

Cited by 33 publications

(32 citation statements)

References 32 publications

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“…Thus, the presented case supports previous suggestions that EBV itself (like various other viruses) is associated with the development of BOS [39,40]. These Wndings challenge our current concepts of BOS pathogenesis and therapy.…”

Section: Wndingssupporting

confidence: 87%

Epstein-Barr virus-associated pneumonia and bronchiolitis obliterans syndrome in a lung transplant recipient

Krumbholz

Sandhaus

Göhlert

et al. 2010

Med Microbiol Immunol

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We report the case of a 25-year-old lung and liver transplant recipient who developed respiratory failure. High levels of Epstein-Barr virus (EBV) genome copies were detectable in respiratory tract specimens, while the search for various other viral, bacterial or fungal pathogens remained empty. Post-transplant lymphoproliferative disease was excluded. Due to the rapid progression of respiratory insufficiency, a re-transplantation of the lung was performed. EBV-encoded small RNAs could be demonstrated by in situ hybridization within pneumocytes and lymphocytes of the explanted lung tissue. The clinical situation improved soon after re-transplantation, and the EBV load detected in the lower respiratory tract decreased significantly.

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Section: Wndingssupporting

confidence: 87%

Epstein-Barr virus-associated pneumonia and bronchiolitis obliterans syndrome in a lung transplant recipient

Krumbholz

Sandhaus

Göhlert

et al. 2010

Med Microbiol Immunol

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“…Recent studies have also called attention to the effect of asymptomatic Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-8), and HHV-7 viremia in solid organ transplantation. [21][22][23][24][25][26][27] A recent study by Bingler et al 23 suggests that a high-load EBV carrier state (Ͼ16,000 genome copies/ ml) is a strong predictor of de novo or recurrent posttransplant lymphoproliferative disorder in a pediatric heart transplant population. An interesting recent study suggests that EBV viremia could also be associated with the development of bronchiolitis obliterans in lung transplant recipients.…”

Section: Discussionmentioning

confidence: 99%

“…An interesting recent study suggests that EBV viremia could also be associated with the development of bronchiolitis obliterans in lung transplant recipients. 24 Although some studies suggest a prognostic value for HHV-6 and HHV-7 in renal and lung transplantation, its importance in heart transplantation has not been yet established. 28 -30 In the most recent series, one case of JC virus-progressive leukoencephalopathy was observed in a patient with a history of early post-transplant Aspergillus infection.…”

Section: Discussionmentioning

confidence: 99%

Changing trends in infectious disease in heart transplantation

Haddad

Deuse

Pham

et al. 2010

The Journal of Heart and Lung Transplantation

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“…Additional associated risk factors include viral infection [29,31,32,[56][57][58][59][60][61][62][63][64], bacterial infection [65][66][67][68] and fungal infection [69][70][71]. Cytomegalovirus infection engages both the innate and adaptive components of immunity and causes upregulation of HLA class I and class II antigens on epithelial cells [72,73], and stimulates and augments the generation of allogeneic immune responses and proinflammatory cytokines [72,74].…”

Section: Other Risk Factorsmentioning

confidence: 99%

An international ISHLT/ATS/ERS clinical practice guideline: diagnosis and management of bronchiolitis obliterans syndrome

et al. 2014

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Bronchiolitis obliterans syndrome (BOS) is a major complication of lung transplantation that is associated with poor survival. The International Society for Heart and Lung Transplantation, American Thoracic Society, and European Respiratory Society convened a committee of international experts to describe and/or provide recommendations for 1) the definition of BOS, 2) the risk factors for developing BOS, 3) the diagnosis of BOS, and 4) the management and prevention of BOS.A pragmatic evidence synthesis was performed to identify all unique citations related to BOS published from 1980 through to March, 2013. The expert committee discussed the available research evidence upon which the updated definition of BOS, identified risk factors and recommendations are based. The committee followed the GRADE (Grading of Recommendation, Assessment, Development and Evaluation) approach to develop specific clinical recommendations.The term BOS should be used to describe a delayed allograft dysfunction with persistent decline in forced expiratory volume in 1 s that is not caused by other known and potentially reversible causes of posttransplant loss of lung function. The committee formulated specific recommendations about the use of systemic corticosteroids, cyclosporine, tacrolimus, azithromycin and about re-transplantation in patients with suspected and confirmed BOS.The diagnosis of BOS requires the careful exclusion of other post-transplant complications that can cause delayed lung allograft dysfunction, and several risk factors have been identified that have a significant association with the onset of BOS. Currently available therapies have not been proven to result in significant benefit in the prevention or treatment of BOS. Adequately designed and executed randomised controlled trials that properly measure and report all patient-important outcomes are needed to identify optimal therapies for established BOS and effective strategies for its prevention. Executive summaryMany lung transplant recipients develop delayed allograft dysfunction that has been traditionally referred to as bronchiolitis obliterans syndrome (BOS), which is thought to be caused by inflammation, destruction and fibrosis of small airways in the lung allograft that leads to obliterative bronchiolitis (OB). Because a definitive diagnosis of OB is difficult to make without a surgical lung biopsy, a decrease in the forced expiratory volume in 1 s (FEV1) has been used as a surrogate marker to identify patients who develop a syndrome of significant and persistent loss of lung allograft function with onset three or more months following transplantation. However, it is now recognised that numerous factors apart from OB can lead to a delayed onset, significant decline in lung function, and these causes of delayed onset graft dysfunction must be carefully excluded when a diagnosis of BOS is made. In general, BOS responds poorly to therapeutic interventions but may stabilise, and some patients may have a significant improvement in FEV1 with certain ther...

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Detection of Epstein–Barr virus DNA in peripheral blood is associated with the development of bronchiolitis obliterans syndrome after lung transplantation

Cited by 33 publications

References 32 publications

Epstein-Barr virus-associated pneumonia and bronchiolitis obliterans syndrome in a lung transplant recipient

Epstein-Barr virus-associated pneumonia and bronchiolitis obliterans syndrome in a lung transplant recipient

Changing trends in infectious disease in heart transplantation

An international ISHLT/ATS/ERS clinical practice guideline: diagnosis and management of bronchiolitis obliterans syndrome

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