Improved Screening for Epstein-Barr Virus Infection in Solid Organ Transplant Patients

Published on in CHOP News

Stylized child iconImprove Outcomes

Why is this important?

Children receiving a solid organ transplant are at high risk for malignancy, especially post-transplant lymphoproliferative disorder (PTLD). PTLD is frequently preceded by Epstein-Barr infection (EBV). Current guidelines recommend EBV lab screening and reduction of immunosuppression medication. This allow viral control and decreases risk of PTLD in patients. Currently, there is uncertainty about how often to screen for EBV and how to respond to positive results, leading to inconsistent testing for EBV across transplant centers.

What we did

We worked with members of Nephrology, Gastroenterology, Pulmonology, Cardiology, Infectious Diseases, and Oncology to optimize EBV screening. Monthly team meetings allowed discussion of positive EBV tests and cases of PTLD, and facilitated a change in the perception of PTLD prevalence. The Transplant Nurse Practitioner group has significantly influenced screening practices for EBV and has increased compliance with EBV screening. We developed reports for nurse practitioners to easily view EBV test results and immunosuppression.

Summary of results

Since March 2016, screening compliance has increased from 60 percent to 95 percent, and this rate continues to be sustained.

Graph: Percent with EBV tests completed post-transplant

Published: May, 2020

Next Steps

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