What does it mean for kidney donation if I am Epstein-Barr Virus (EBV) antibody positive?

EBV Antibody Positive Status in Kidney Donation

Being EBV antibody positive as a potential kidney donor means you have previously been infected with Epstein-Barr virus and have developed immunity, which is generally favorable for donation as it reduces risks of post-transplant complications for the recipient. 1

Significance of EBV Antibody Status in Kidney Donation

• EBV antibody testing is a standard part of the infectious disease screening required for all living kidney donors 1, 2
• EBV antibody positivity indicates prior infection and development of immunity to the virus 3
• This is considered a favorable finding in the donor evaluation process, particularly when donating to EBV-negative recipients 1

Implications for Donation Process

• Your EBV-positive status will be matched with the recipient's EBV status to assess risk 1
• Testing for EBV must be current within 28 days of donation to ensure accuracy 2
• Your EBV status will be documented as part of the standard infectious disease screening profile 1, 2

Recipient Risk Assessment

• The highest risk scenario in kidney transplantation is an EBV-negative recipient receiving a kidney from an EBV-positive donor 1, 3
• In this scenario, the recipient has a higher risk of developing post-transplant lymphoproliferative disorder (PTLD) 4, 3
• However, this risk is manageable with proper monitoring and prophylaxis 1, 4

Risk Reduction Strategies for Recipients

• If your kidney goes to an EBV-negative recipient, they will typically receive:
  • More intensive EBV monitoring post-transplant 1
  • Possible antiviral prophylaxis with acyclovir, valacyclovir, or ganciclovir 4
  • Regular monitoring of EBV viral load during the first post-transplant year 1
  • Possible reduction in immunosuppression if EBV viral load increases 1

Common Misconceptions and Pitfalls

• Being EBV-positive does NOT disqualify you from donation 1, 2
• Unlike hepatitis B or C, EBV positivity is extremely common in the adult population and is not considered a contraindication to donation 1
• Your EBV status will be considered alongside other infectious disease screening results (HIV, hepatitis B and C, CMV, syphilis) as part of the standard donor evaluation 1, 2

What You Need to Know

• Your EBV antibody positive status indicates past infection and immunity 3
• This is a normal finding in most adults and does not affect your eligibility to donate 1
• The transplant team will match your EBV status with potential recipients to minimize risks 1
• The recipient's transplant team will implement appropriate monitoring and prophylaxis strategies based on your EBV status 1, 4