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Nephrol Dial Transplant (2003) 18: 2638-2643
© 2003 European Renal Association-European Dialysis and Transplant Association

Original Article

Epstein–Barr virus latency in kidney specimens from transplant recipients

Luis Fernando Arias1, Susana Hernández3, Dolores Prats2, Ana Sanchez-Fructoso2, María Márques2, Teresa Alvarez1, Alberto Barrientos2 and Julia Blanco1

1Department of Pathology and 2Department of Nephrology, Hospital Clínico San Carlos, Madrid and 3National Center for Oncologic Research (CNIO), Madrid, Spain

Correspondence and offprint requests to: Julia Blanco, Department of Pathology, Hospital Clínico San Carlos, C/ de Martín Lagos s/n 28040, Madrid, Spain. Email: mblanco.hcsc{at}salud.madrid.org

Background. Epstein–Barr virus (EBV) infection is common in immunosuppressed patients and can lead to life threatening lymphoproliferative diseases. Small numbers of cells infected by EBV have been detected in human tissues, transplanted or non-transplanted. Little is known about EBV latency in the allograft kidneys of patients without post-transplant lymphoproliferative disease (PTLD). The aims of this study were to look for the presence of EBV-encoded small RNAs (EBER) in allograft kidneys and to quantify their expression.

Methods. We analysed 62 allograft nephrectomies and 20 native kidneys to determine the presence of EBV; we also quantified its expression and calculated its ratios to CD45 and CD20 cells. The techniques used were: tissue microarray, EBER-1- and 2-specific in situ hybridization and immunohistochemistry.

Results. EBER expression was detected in 30.6% of transplanted kidneys and 5% of non-transplanted kidneys. In the positive specimens, a mean of 8.2 cells/1.57 mm2 expressed the EBERs (range 1–38 cells). The ratios of EBER-positive (+) cells to CD45 or CD20 cells were 1.7 ± 2.4% (range 0.1–8.1%) and 8.4 ± 10.9% (range 0.5–34.4%), respectively. No relationship was found between anti-T-cell treatment and EBER expression in the failed allografts.

Conclusions. In failed kidney allografts, a small number of lymphocytes can express EBV latency. The number of EBER+ cells is smaller than in PTLD. Studies of functioning grafts are necessary to better understand the clinical relevance of this expression.

Keywords: EBER; Epstein–Barr virus; in situ hybridization; kidney transplantation; tissue microarray


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