What question did this study set out to answer?

The study aims to detect and analyze the prevalence of EBV and HCMV infections in pediatric heart transplant recipients.

January 10, 2026BMC Pediatrics0 citationsOpen Access

Diagnosis of EBV and HCMV infections in pediatric heart transplant recipients

FGFatemeh GabelehTarbiat Modares University MMMohammad Reza MahdaviRazi University MNMohammad Hadi Karbalaie NiyaIran University of Medical Sciences

Key Result

All pediatric heart transplant recipients were CMV seropositive, with EBV detected in 25% of plasma samples post-transplant, indicating significant viral infection risks.

Key Points

The study aims to detect and analyze the prevalence of EBV and HCMV infections in pediatric heart transplant recipients.
Conducted a cross-sectional study with 28 hospitalized children awaiting heart transplantation.
Collected plasma and urine samples at multiple time points: during surgery and one and two months post-transplant.
Performed molecular tests to detect EBV and HCMV infections and assess viral loads.
Analyzed the patients’ clinical information alongside viral detection.
All patients were CMV seropositive; 64.28% showed EBV-IgG antibodies.
CMV infections were detected in 10.7%, 7.1%, and 7.1% of plasma samples at the three time points.
EBV infections in plasma were noted at rates of 25%, 22.2%, and 25% respectively.
7.1% of recipients received CMV-infected heart tissue, while 14.3% received EBV-infected tissue.

Structured PICO

Population

28 hospitalized pediatric heart transplant recipients (mean age 11.5 ± 4.5 years, 57.1% female) diagnosed with cardiac disorders such as dilated cardiomyopathy, restrictive cardiomyopathy, hypertrophic cardiomyopathy, and tetralogy of Fallot.

Outcome

Detection of CMV and EBV infections and viral loads in plasma (at surgery, 1 month, and 2 months post-transplant), urine (2 months post-transplant), and donor heart tissue.surrogate

Pediatric heart transplant recipients have a substantial prevalence of CMV and EBV infections post-transplant, emphasizing the need for long-term monitoring and effective prophylactic strategies.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Viral infections, including human cytomegalovirus (HCMV) and Epstein–Barr Virus (EBV), are significant agents that can cause serious complications and death in heart transplant recipients. This study aims to detect CMV and EBV infections in pediatric heart transplant recipients. We conducted a cross-sectional study involving 28 hospitalized children who were candidates for heart transplantation. Plasma samples were collected at three time points: during surgery, one month after transplantation, and two months after transplantation. Urine samples were collected two months post-transplant. Heart tissue specimens from donors were taken from the aorta wall, pulmonary artery, and left atrium. Molecular tests were performed to detect EBV and CMV infections and viral loads. The patients’ clinical information was recorded and analyzed. All 28 patients were CMV seropositive (100%), and 64.28% had EBV-IgG. CMV infection was detected in 10.7%, 7.1%, and 7.1% of plasma samples at the three time points, respectively, and in 7.1% of urine samples two months post-transplant. EBV infection in plasma was more frequent than CMV, with detection rates of 25%, 22.2%, and 25% at the three time points, respectively. Two recipients (7.1%) received CMV-infected heart tissue, and four patients (14.3%) received EBV-infected heart tissue. The immunosuppressive state in solid organ transplantation can trigger the reactivation and re-infection of CMV and EBV, leading to CMV disease and EBV-associated complications in heart transplant recipients. Our findings emphasize the need for long-term monitoring, effective prophylactic strategies, and a balanced approach to immunosuppression to mitigate the risks associated with these viral infections.

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