Abstract Objectives: Many children with chronic liver disease require a liver transplant. These patients are prone to various infections, including Epstein-Barr virus infection. This study sought to measure the Epstein- Barr viral load by polymerase chain reaction before a liver transplant. Materials and Methods: This cross-sectional study was done at the Shiraz University of Medical Sciences, Shiraz, Iran, in 2011. All patients were aged younger than 18 years with chronic liver disease and were candidates for a liver transplant at the Shiraz Nemazee Hospital Organ Transplant Center. They had been investigated regarding their demographic characteristics, underlying disease, laboratory findings, and Epstein-Barr viral load by real-time TaqMan polymerase chain reaction. Results: Ninety-eight patients were studied and the mean age was 6.5 ± 5.9 years. Cryptogenic cirrhosis was the most-prevalent reason for liver transplant, and the death rate before a transplant was 15%. Among the study subjects, 6 had measurable Epstein-Barr viral load by polymerase chain reaction before the transplant, and 4 of them had considerably higher Epstein-Barr viral loads (more than 1000 copies/mL). Conclusions: With respect to the close prevalence of posttransplant lymphoproliferative disease (6%) and the high Epstein-Barr viral load in the patients before a transplant (4%), high pretransplant Epstein-Barr viral load can be considered a risk factor for posttransplant lymphoproliferative disorder. Key words: Chronic liver disease, Liver transplant, Epstein-Barr virus. Introduction Liver transplant is the standard treatment of choice for end-stage liver diseases. 1 Recently, taking care of children with advanced liver diseases has focused mainly on finding a liver for transplant; however, today, more attention is paid to long-term follow-up of patients, reduction of adverse effects of immunosuppressive drugs, and reaching normal growth. 1 Today, measuring Epstein-Barr Virus (EBV) DNA in the serum is an important means for diagnosing EBV-related diseases because EBV is a latent virus and can be reactivated by immune suppression after transplant. High levels of EBV in the blood (demonstrated by real-time polymerase chain reaction) has a close relation with posttransplant lymphoproliferative disorder (PTLD) and can be considerably reduced by appropriate treatment. 2 Because most children with chronic liver diseases finally require a liver transplant, 3 they are susceptible to various infections, including infection with EBV that can lead to different problems (eg, PTLD), which are accompanied by high death rates. 4,5 Thus, preventing PTLD is critical in reducing mortality rates. Until now, several studies have serially measured EBV viral load after transplant and in case of high EBV viral load, have used treatment strategies to prevent PTLD. 6,7 ArtIcle Epstein-Barr Viral Load Before a Liver Transplant in Children With Chronic Liver Disease Nader Shakibazad, 1 Naser Honar, 1 Seyed Mohsen Dehghani, 2 Abdolvahab Alborzi 3 Copyright © Başkent University 2014 Printed in Turkey. All Rights Reserved. From the 1 Department of Pediatrics and the 2 Shiraz Transplant Research Center, Shiraz University of Medical Sciences, School of Medicine, Nemazee Teaching Hospital; and the 3 Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Acknowledgements: This article was adopted from Nader Shakibazad’s thesis for Specialization in Pediatrics. The authors would like to thank the Research Vice-Chancellor of Shiraz University of Medical Sciences, Shiraz, Iran, for financially supporting the study with grant number 2594. The Research Improvement Center of Shiraz University of Medical Sciences, and Ms. A. Keivanshekouh are also appreciated for improving the use of English in the manuscript. The authors have no conflicts of interest to declare. Corresponding author: Nader Shakibazad, Department of Pediatrics, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran 71937-11351 Phone/Fax: +98 7116 474 298 Cellular Phone: +98 9171 709 465 E-mail: shakibn@sums.ac.ir Experimental and Clinical Transplantation (2014) 6: 534-538 DOI: 10.6002/ect.2013.0100