Epstein–Barr virus (EBV) is strongly associated with the development of post-transplant lymphoproliferative disorder (PTLD) in pediatric liver transplant recipients. PTLD is one of the most common malignancies following liver transplantation and is associated with significant morbidity and mortality. Factors such as EBV–serostatus mismatch and prolonged or high levels of immunosuppression impact a patient’s risk of developing PTLD. While pre-transplant EBV serological screening and post-transplant monitoring of EBV-DNA levels are strongly recommended, universal guidelines for its prevention and management are lacking. Due to a lack of robust prospective studies, current clinical practices vary widely. The treatment of PTLD typically involves reducing immunosuppression and using targeted therapies such as rituximab, or chemotherapy for refractory cases. This review aims to address our current understanding of EBV’s relationship with PTLD, evaluate the available treatment modalities, and highlight evolving strategies for using EBV as a biomarker for PTLD screening and prevention.

Abernethy malformation is a rare congenital extrahepatic portosystemic shunt resulting from the persistence of embryonic vessels in the splanchnic venous system. There are 2 known types of Abernethy malformations: type I and II; both of which involve aberrant drainage of the portal venous blood into the inferior vena cava. Here, we detail the anatomy as well as clinical, surgical, and interventional management of 4 patients with Abernethy malformations. In addition, we detail a patient with a previously undescribed anatomic variant of the Abernethy type II malformation: a portosystemic shunt into an interrupted inferior vena cava in which central venous return was provided through the azygous/hemiazygos system.