Prospective monitoring of epstein-barr virus DNA in adult renal transplant recipients during the early posttransplant period: Role of mycophenolate mofetil

BACKGROUND.: Epstein-Barr virus (EBV) is associated with posttransplant lymphoproliferative disease. We monitored the incidence of EBV viraemia in adult renal transplant recipients and investigated the association with clinical parameters. METHODS.: Whole blood from 115 renal transplant patients was tested regularly by quantitative polymerase chain reaction (PCR) assay for EBV DNA during the first 90 days posttransplantation. RESULTS.: Sixty four of 115 (56%) patients had detectable EBV DNA in blood (>100 copies/mL) on at least one occasion. The median time to first DNA detection was 15 days post-transplant and median viral load was 598 copies/mL (range 119ĝ€"53,649 copies/mL). Multivariate Cox-regression analyses showed that patients receiving mycophenolate mofetil (MMF) on the day of transplant had a significantly lower risk of EBV viraemia compared to those who received no MMF (Hazard ratio=0.518, 95% CI 0.307ĝ€"0.875, p=0.014). CONCLUSIONS.: EBV viraemia is common during the early posttransplant period in adult renal transplant recipients. Our results suggest a role of MMF in preventing EBV viraemia, however further work is required to identify the mechanism(s) involved.