118: Specific pattern of serum HGF and broncho-alveolar lavage MMP-9 in acute and chronic lung transplant rejection

Abstract

single, 3 heart-lung) survived more than 3 months following transplant. Only 1 of 194 patients (0.05%) developed PTLD. The patient was EBV seropositive prior to transplant, but CMV negative with a CMV positive donor. She had complete resolution of PTLD with Rituximab, and upon autopsy, there was no evidence of recurrent PTLD. 122 of 194 patients (63%) were documented to be EBV seropositive prior to transplantation, while 20 (10%) were EBV seronegative. Repeat EBV serologies were available for 6 of 20 patients who were previously negative. 5 of the 6 became EBV seropositive following transplantation with no evidence of PTLD. Of the 113 living patients, 82 (72.6%) remain on valgancyclovir, 3 (2.7%) are on acyclovir, and 28 (24.8%) are no longer on antiviral therapy. Conclusions: The incidence of PTLD in patients undergoing lung transplantation at UCSF is only 0.05%, with 0% mortality secondary to PTLD, which is much lower than previously reported. Antiviral therapy may decrease the incidence of PTLD either by direct inhibitory effects on EBV or by indirectly preventing CMV disease. The implications of this study are limited by its small sample size and retrospective design, but further investigation is indicated to determine whether antiviral prophylaxis decreases the incidence of PTLD.