Allen UD, Preiksaitis JK; AST Infectious Diseases Community of Practice. Post-transplant lymphoproliferative disorders, Epstein-Barr virus infection, and disease in solid organ transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33:e13652.
Babel N, Volk HD, Reinke P. BK polyomavirus infection and nephropathy: the virus-immune system interplay. Nat Rev Nephrol. 2011;7:399-406.
Fryer JF, Heath AB, Minor PD; Collaborative Study Group. A collaborative study to establish the 1st WHO International Standard for human cytomegalovirus for nucleic acid amplification technology. Biologicals. 2016;44:242-251.
Fryer JF, Heath AB, Wilkinson DE, et al; Collaborative Study Group. A collaborative study to establish the 1st WHO International Standard for Epstein-Barr virus for nucleic acid amplification techniques. Biologicals. 2016;44:423-33.
Fryer JF, Heath AB, Wilkinson DE, et al; Collaborative Study Group. Collaborative study to evaluate the proposed 1st WHO international standard for Epstein-Barr virus (EBV) for nucleic acid amplification technology (NAT)-based assays. World Health Organization website. Published 2011. Accessed March 2, 2021. https://apps.who.int/iris/handle/10665/70781
Gouvêa ALF, Cosendey RIJ, Nascimento ALR, et al. BK polyomavirus nephropathy in two kidney transplant patients with distinct diagnostic strategies for BK virus and similar clinical outcomes: two case reports. J Med Case Reports. 2017;11:146.
Green M, Michaels MG. Epstein - Barr virus Infection and Post-Transplant Lymphoproliferative Disorder. Am J Transplant. 2013;13:41-54.
Haynes RJ, Kline MC, Toman B, et al. Standard reference material 2366 for measurement of human cytomegalovirus DNA. J Mol Diagn. 2013;15:177-185.
Hirsch HH, Randhawa P; AST Infectious Diseases Community of Practice. BK polyomavirus in solid organ transplantation. Am J Transplant. 2013;13:Suppl 4:179-188.
Kotton CN, Kumar D, Caliendo AM, et al; The Transplantation Society International CMV Consensus Group. The third International Consensus guidelines on the management of cytomegalovirus in solid-organ transplantation. Transplantation. 2018;102:900-931.
Nijland ML, Kersten MJ, Pals ST, et al. Epstein-Barr virus-positive posttransplant lymphoproliferative disease after solid organ transplantation: pathogenesis, clinical manifestations, diagnosis, and management. Transplant Direct. 2015;2:e48.
O'Donnell PH, Swanson K, Josephson MA, et al. BK virus infection is associated with hematuria and renal impairment in recipients of allogeneic hematopoetic stem cell transplants. Biol Blood Marrow Transplant. 2009;15:1038-1048.e1.
Safa K, Elias N, Gilligan HM, et al. Successful living kidney donation after COVID-19 infection. Transplantation. 2021;105:e4-e5.
Semenova T, Lupo J, Alain S, et al. Multicenter evaluation of whole-blood epstein-barr viral load standardization using the WHO international standard. J Clin Microbiol. 2016;54:1746-1750.
Tan SK, Milligan S, Sahoo MK, et al. Calibration of BK virus nucleic acid amplification testing to the 1st WHO international standard for BK virus. J Clin Microbiol. 2017;55:923-930.
United States Department of Health & Human Services website. Organ procurement and transplantation network - national data. Published 2021. Accessed February 8, 2021. https://optn.transplant.hrsa.gov/data/view-data-reports/national-data/#
United States Food and Drug Administration website. Draft guidance for industry, food and drug administration staff, and clinical laboratories. Published October 3, 2014. Accessed March 1, 2021. https://www.fda.gov/media/89841/download

As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.

Faculty

Camille Nelson Kotton, MD

Associate Professor of Medicine
Harvard Medical School
Clinical Director
Transplant and Immunocompromised Host Infectious Diseases
Massachusetts General Hospital
Boston, Massachusetts

Disclosures

Disclosure: Camille Nelson Kotton, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Roche Diagnostics

Michael Green, MD, MPH

Division of Infectious Diseases
UPMC Children's Hospital of Pittsburgh
Professor of Pediatrics and Surgery
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania

Disclosures

Disclosure: Michael Green, MD, MPH, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: ITB-Med

Daniel C. Brennan, MD

Medical Director
Comprehensive Transplant Center
Professor of Medicine
Johns Hopkins School of Medicine
Baltimore, Maryland

Disclosures

Disclosure: Daniel C. Brennan, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Allovir; Amplyx; CareDx; Medeor; Natera; Sanofi; Veloxis
Served as a speaker or a member of a speakers bureau for: CareDx; Veloxis
Received grants for clinical research from: Allovir; Amplyx; CareDx; Natera
Owns stock, stock options, or bonds from: Consultant for Medeor

Editors

Julia Muino, MA

Medical Education Director, Medscape, LLC

Disclosures

Disclosure: Julia Muino, MA, has disclosed no relevant financial relationships.

Anita A. Galdieri, PharmD, RPh

Senior Scientific Content Manager, Medscape, LLC

Disclosures

Disclosure: Anita A. Galdieri, PharmD, RPh, has disclosed no relevant financial relationships.

CME Reviewer

Stephanie Corder, ND, RN, CHCP

Associate Director, Accreditation and Compliance, Medscape, LLC

Disclosures

Disclosure: Stephanie Corder, ND, RN, CHCP, has disclosed no relevant financial relationships.

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.

CME / ABIM MOC

Post-Transplantation Diagnostics for Epstein-Barr Virus and BK Virus Infection

Authors: Camille Nelson Kotton, MD; Michael Green, MD, MPH; Daniel C. Brennan, MD
CME / ABIM MOC Released: 3/9/2021
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 3/9/2022, 11:59 PM EST

Start Activity

Target Audience and Goal Statement

This activity is intended for primary care physicians, nephrology specialists, and infectious disease specialists.

The goal of this activity is to improve the timely identification of post-transplant infections such as Epstein-Barr virus (EBV) and BK virus (BKV) in patients.

Upon completion of this activity, participants will:

Have increased knowledge regarding the
- Key distinguishing characteristics between laboratory-developed tests (LDTs) and in vitro diagnostics (IVDs)
- Considerations for EBV testing in the post-transplant setting
- Considerations for BKV test interpretation in the post-transplant setting
Demonstrate greater confidence in their ability to
- Coordinate with the multidisciplinary team to provide timely monitoring of infections among transplant recipients

Disclosures

Faculty

Camille Nelson Kotton, MD

Associate Professor of Medicine
Harvard Medical School
Clinical Director
Transplant and Immunocompromised Host Infectious Diseases
Massachusetts General Hospital
Boston, Massachusetts

Disclosures

Disclosure: Camille Nelson Kotton, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Roche Diagnostics

Michael Green, MD, MPH

Division of Infectious Diseases
UPMC Children's Hospital of Pittsburgh
Professor of Pediatrics and Surgery
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania

Disclosures

Disclosure: Michael Green, MD, MPH, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: ITB-Med

Daniel C. Brennan, MD

Medical Director
Comprehensive Transplant Center
Professor of Medicine
Johns Hopkins School of Medicine
Baltimore, Maryland

Disclosures

Disclosure: Daniel C. Brennan, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Allovir; Amplyx; CareDx; Medeor; Natera; Sanofi; Veloxis
Served as a speaker or a member of a speakers bureau for: CareDx; Veloxis
Received grants for clinical research from: Allovir; Amplyx; CareDx; Natera
Owns stock, stock options, or bonds from: Consultant for Medeor

Editors

Julia Muino, MA

Medical Education Director, Medscape, LLC

Disclosures

Disclosure: Julia Muino, MA, has disclosed no relevant financial relationships.

Anita A. Galdieri, PharmD, RPh

Senior Scientific Content Manager, Medscape, LLC

Disclosures

Disclosure: Anita A. Galdieri, PharmD, RPh, has disclosed no relevant financial relationships.

CME Reviewer

Stephanie Corder, ND, RN, CHCP

Associate Director, Accreditation and Compliance, Medscape, LLC

Disclosures

Disclosure: Stephanie Corder, ND, RN, CHCP, has disclosed no relevant financial relationships.

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.

Accreditation Statements

In support of improving patient care, Medscape, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

For Physicians

Medscape, LLC designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.50 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Aggregate participant data will be shared with commercial supporters of this activity.

Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

Read about the target audience, learning objectives, and author disclosures.
Study the educational content online or print it out.
Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.

From Medscape Education Cardiology

CME / ABIM MOC

Post-Transplantation Diagnostics for Epstein-Barr Virus and BK Virus Infection

Authors: Camille Nelson Kotton, MD; Michael Green, MD, MPH; Daniel C. Brennan, MDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME / ABIM MOC Released: 3/9/2021

Valid for credit through: 3/9/2022, 11:59 PM EST

processing....

Contents of This CME Activity

All sections of this activity are required for credit.

Detecting Infection in Transplant Recipients

Dr Camille Nelson Kotton provides an overview of diagnostics to detect viral infection in transplant recipients.
Camille Nelson Kotton, MD

PCR-Based Measurement of EB Viral Load in Peripheral Blood

Dr Michael Green discusses PCR-based measurement of EBV viral loads in the peripheral blood to detect infection in transplant recipients.
Michael Green, MD, MPH

Diagnostics to Detect BKV Infection in Kidney Transplant Recipients

Dr Daniel C. Brennan reviews the diagnostics used to detect BKV infection in kidney transplant recipients.
Daniel C. Brennan, MD

Transplant in the COVID-19 Era

Dr Camille Nelson Kotton discusses the effects of the COVID-19 pandemic on transplant.
Camille Nelson Kotton, MD

Educational Impact Challenge

The goal of this activity is to improve the timely identification of post-transplant infections such as Epstein-Barr virus (EBV) and BK virus (BKV) in patients.

Before you begin this activity, please assess your clinical knowledge by completing this brief survey. Answering these questions again after the activity will allow you to see what you learned and to compare your answers with those of your peers.

Page 1 of 7

CME / ABIM MOC Information Download Slides

Activity Transcript

Print
Like Tweet

Disclaimer

The educational activity presented above may involve simulated, case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient, whether living or deceased, is intended or should be inferred. The material presented here does not necessarily reflect the views of Medscape, LLC, or any individuals or commercial entities that support companies that support educational programming on medscape.org. These materials may include discussion of therapeutic products that have not been approved by the US Food and Drug Administration, off-label uses of approved products, or data that were presented in abstract form. These data should be considered preliminary until published in a peer-reviewed journal. Readers should verify all information and data before treating patients or employing any therapies described in this or any educational activity. A qualified healthcare professional should be consulted before using any therapeutic product discussed herein.

References

Faculty and Disclosures

Faculty

Camille Nelson Kotton, MD

Michael Green, MD, MPH

Daniel C. Brennan, MD

Editors

Julia Muino, MA

Anita A. Galdieri, PharmD, RPh

CME Reviewer

Stephanie Corder, ND, RN, CHCP

Peer Reviewer

CME / ABIM MOC

Post-Transplantation Diagnostics for Epstein-Barr Virus and BK Virus Infection

Target Audience and Goal Statement

Disclosures

Faculty

Camille Nelson Kotton, MD

Michael Green, MD, MPH

Daniel C. Brennan, MD

Editors

Julia Muino, MA

Anita A. Galdieri, PharmD, RPh

CME Reviewer

Stephanie Corder, ND, RN, CHCP

Peer Reviewer

Accreditation Statements

For Physicians

Instructions for Participation and Credit

Post-Transplantation Diagnostics for Epstein-Barr Virus and BK Virus Infection

Contents of This CME Activity

Detecting Infection in Transplant Recipients

PCR-Based Measurement of EB Viral Load in Peripheral Blood

Diagnostics to Detect BKV Infection in Kidney Transplant Recipients

Transplant in the COVID-19 Era

Educational Impact Challenge