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Keywords:

  • post-transplant lymphoproliferalive disease;
  • Epstein–Barr virus;
  • solid organ transplant;
  • acyclovir;
  • ganciclovir;
  • antiviral;
  • immunoprophylaxis;
  • tacrolimus

Abstract: The recognition of the importance of Epstein–Barr virus (EBV) infection, including EBV-associated post-transplant lymphoproliferative disease (PTLD), has led to a new focus on the prevention of this problem. This paper reviews the scientific rationale behind, and clinical experience with, the use of chemoprophylaxis (using acyclovir or ganciclovir) and immunoprophylaxis (using intravenous immunoglobulin) in the prevention of EBV/PTLD. While some centers have already introduced the use of one or both of these agents as standard prophylaxis against the development of this complication, published data in support of these protocols are currently lacking. Well designed clinical trials are necessary to evaluate the potential role of both antiviral and immunoglobulin agents in the prevention of EBV/PTLD in organ transplant recipients.