Viral infection after solid organ or stem cell transplantation

PD Susanne Delecluse, MD, MHBA

Patients with an immunodeficiency, and in particular transplant recipients, have a reduced ability to control infectious agents. In the presence of a diminished functional T cell response, a substantial proportion of individuals who were previously infected with EBV cannot prevent infected B cells from resuming proliferation (Figure 1 and 2). Transplant recipients, in particular children, who undergo primary infection whilst already under immunosuppressive treatment carry an even higher risk of EBV-associated diseases like post-transplant lymphoproliferative disorders (PTLD). We have previously studied the viral strains that are found in EBV-associated nasopharyngeal carcinomas and gastric carcinomas and found that these strains exhibit specific properties (Tsai et al. Cell reports 2013, Shumilov, Tsai et al Nature comm. 2017). We are now exploring the hypothesis that the risk of PTLD is linked with infections with EBV strains endowed with higher transforming abilities. We have recruited a collective of patients with EBV reactivation after transplantation and have established cell lines infected with EBV from their peripheral blood. We aim to study multiple parameters such as viral and cellular protein implicated in EBV-mediated transformation and microRNA expression in primary cells and in the cell lines that were established from these patients.

This project results from a close cooperation with the Kidney Center Heidelberg e.v., the Department of Haematology as well as the Institute of Virology from the University of Heidelberg.