esteban Frauca, et al.: Cytomegalovirus and Epstein-Barr Virus Infection in Pediatric Liver Transplants

Cytomegalovirus and Epstein-Barr virus infections remain one of the main concerns in the postoperative care of children with a liver transplantation. Most of the pediatric liver transplant recipients are seronegative for cytomegalovirus and/or Epstein-Barr virus at transplantation and this places them at marked risk for the development of cytomegalovirus/Epstein-Barr virus-related diseases. In immunosuppressed patients, cytomegalovirus presents a wide range of direct and indirect effects and cytomegalovirus infection is an independent risk factor for graft loss and death. However, the availability of effective therapies, sensitive assays for diagnosis and surveillance, together with the development of effective prevention strategies have dramatically decreased the impact of cytomegalovirus infection and disease on the outcome of pediatric liver transplant recipients and cytomegalovirus infection is no longer a significant cause of morbidity or mortality in these patients . In contrast, Epstein-Barr virus infection still represents a major cause of complications after transplantation due to its well-documented capacity to induce the development of lymphoproliferative disorders. Identifying those transplanted children at an actual risk of posttransplant lymphoproliferative disease development and defining effective and safe preventive strategies remain a challenge. Here, we describe the clinical consequences of these viral infections and their impact on the outcome of children with a liver transplantation and review the different promoted strategies for prevention and treatment. (Trends in Transplant. 2009;3:153-64)