{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T14:09:26Z","timestamp":1785247766111,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:00:00Z","timestamp":1740614400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>One strategy to minimize the risk of posttransplant lymphoproliferative disorder (PTLD) is to avoid an Epstein\u2013Barr Virus (EBV) mismatch through kidney paired donation. We aimed to estimate the incidence of PTLD in EBV\u2010negative kidney transplant recipients with EBV\u2010positive donors (D+\/R\u2212) and evaluate the excess risk of death following the occurrence of PTLD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included adult patients in OPTN database who underwent kidney transplants between 2012 and 2022. Cox regression analysis was employed to evaluate the impact of EBV serostatus on the development of PTLD, and to assess mortality following PTLD diagnosis in D+\/R\u2212 individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 179\u00a0068 patients were included, with 92.8% in the R+, 6.4% in the D+\/R\u2212, and 0.8% in the D\u2212\/R\u2212 group. D+\/R\u2212 exhibited a significantly higher risk of PTLD compared to R+ and D\u2212\/R\u2212 groups. D+\/R\u2212 had a greater risk of PTLD when compared to D\u2212\/R\u2212 recipients (aHR: 3.82; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). Among D+\/R\u2212 recipients, those who developed PTLD had a significantly higher risk of mortality (aHR: 2.28; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001 in deceased donor kidney transplant [DDKT] and aHR: 5.22; <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.001 in living donor kidney transplant [LDKT]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>D+\/R\u2212 recipients have nearly a fourfold higher risk of PTLD compared to D\u2212\/R\u2212 recipients, suggesting that choosing an EBV D\u2212\/R\u2212 transplant could reduce the PTLD risk by about 73%. This data is crucial for counseling EBV\u2010negative patients considering kidney paired donation to avoid an EBV serostatus mismatch.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.70117","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T05:44:20Z","timestamp":1741758260000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Impact of Epstein\u2013Barr Virus Serostatus Mismatch in Adult Kidney Transplant Recipients: An Analysis of the 2012\u20132022 OPTN Database"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7564-0844","authenticated-orcid":false,"given":"Namrata","family":"Parikh","sequence":"first","affiliation":[{"name":"Department of Transplant Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2603-360X","authenticated-orcid":false,"given":"Rose Mary","family":"Attieh","sequence":"additional","affiliation":[{"name":"Department of Transplant Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4886-0897","authenticated-orcid":false,"given":"Hani M.","family":"Wadei","sequence":"additional","affiliation":[{"name":"Department of Transplant Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1814-7003","authenticated-orcid":false,"given":"Michael A.","family":"Mao","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7571-2542","authenticated-orcid":false,"given":"Shennen A.","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Transplant Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3916-3566","authenticated-orcid":false,"given":"Cemal Burcin","family":"Taner","sequence":"additional","affiliation":[{"name":"Department of Transplant Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9973-0470","authenticated-orcid":false,"given":"Tambi","family":"Jarmi","sequence":"additional","affiliation":[{"name":"Department of Transplant Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9954-9711","authenticated-orcid":false,"given":"Wisit","family":"Cheungpasitporn","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Mayo Clinic  Rochester Minnesota 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