Efficacy of quantitative analysis of Epstein-Barr virus-infected peripheral blood lymphocytes by in situ hybridization of EBER1 after living-related liver transplantation: a case report

Transplantation. 1997 May 15;63(9):1363-6. doi: 10.1097/00007890-199705150-00029.


Background: We describe a 1-year-old female who underwent living-related liver transplantation for biliary atresia and developed Epstein-Barr virus (EBV)-related posttransplant lymphoproliferative disorder. This disorder was resolved after withdrawal of immunosuppression therapy and administration of a high dose of acyclovir.

Methods: To quantify the extent of EBV activation and EBV load in peripheral blood, we measured the levels of EBV-infected peripheral lymphocytes by in situ hybridization (ISH) of EBV-encoded small mRNA 1 (EBER1).

Results: The decline in the number of EBER1-positive lymphocytes (from 362/50,000 mononuclear cells to 0/50,000) after treatment was in accord with the patient's clinical improvement.

Conclusions: This finding showed that quantitative analysis of EBV-infected peripheral lymphocytes by ISH of EBER1 is very useful for monitoring the EBV load and response to treatment of patients with EBV-related disorders. Furthermore, ISH may become an important tool for the early diagnosis and prevention of life-threatening posttransplant lymphoproliferative disorder in posttransplant patients.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / therapeutic use
  • Antiviral Agents / therapeutic use
  • Female
  • Herpesviridae Infections / blood*
  • Herpesviridae Infections / etiology
  • Herpesvirus 4, Human / metabolism
  • Humans
  • In Situ Hybridization
  • Infant
  • Liver Transplantation / adverse effects*
  • Lymphocytes / virology*
  • Lymphoproliferative Disorders / blood
  • Lymphoproliferative Disorders / etiology
  • Lymphoproliferative Disorders / virology
  • RNA, Viral / blood*
  • T-Lymphocytes, Cytotoxic / immunology
  • Transplantation, Homologous
  • Viral Load
  • Virus Activation


  • Antiviral Agents
  • Epstein-Barr virus encoded RNA 1
  • RNA, Viral
  • Acyclovir