Risk Factors and Survival Analysis of Epstein–Barr Virus Infection After Pediatric Liver Transplantation
Yujun Li, Yuanyuan Li, Zhenyu Xie, Chengkun Luo, Jiulin SongABSTRACT
Objective
To explore the risk factors affecting Epstein–Barr virus (EBV) infection after pediatric liver transplantation (PLT) and analyze the survival outcomes of EBV infection in PLT.
Methods
A retrospective analysis was conducted on clinical data from 251 pediatric patients (≤ 14 years) who underwent liver transplantation at West China Hospital of Sichuan University between January 1, 2008, and February 1, 2025. The cohort included 129 males and 122 females, with a median transplant age of 15 (10, 48) months. Patients were categorized into noninfection ( n = 110), asymptomatic infection ( n = 85), and symptomatic infection ( n = 56) groups based on EBV infection status and severity. Clinical data were collected for univariate analysis, multivariate analysis, and Kaplan–Meier survival analysis.
Results
Multivariate logistic regression analysis identified tacrolimus trough concentration, preoperative EBV infection in the recipient, and transplant age as independent risk factors for post‐transplant EBV infection. The 1‐, 3‐, and 5‐year survival rates were 94.7%, 92.2%, and 89.4% in the EBV‐infected group, compared to 95.3%, 94.3%, and 93.1% in the noninfected group, with no significant difference in 5‐year survival between the two groups ( p = 0.376).
Conclusion
EBV infection is common after PLT, with a high incidence and potential for severe complications. Tacrolimus trough concentration, preoperative EBV infection, and age are independent risk factors for post‐transplant EBV infection. EBV infection does not significantly impact long‐term survival.