{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T07:05:47Z","timestamp":1763535947173,"version":"3.41.2"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,1,17]],"date-time":"2022-01-17T00:00:00Z","timestamp":1642377600000},"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":["Pediatric Transplantation"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>PTLD is a clinical condition with high mortality. Monitoring EBV replication can be a useful tool to avoid the development of PTLD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This was a retrospective analysis of 428 pediatric patients who underwent liver transplantation between 1989 and 2016. The patients were divided into 2\u00a0groups (transplanted before 2006, when PCR\u2010EBV was not monitored, and after 2006, when PCR\u2010EBV monitoring was started). Patients with continuous PCR measurements for EBV were evaluated for the impact of a reduction in immunosuppression or a change in immunosuppressants on the number of viral copies. A logistic regression model was applied to evaluate factors related to PTLD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of PTLD was 4.2%. After monitoring patients with PCR for EBV levels, a predominance of the most severe, monomorphic form of lymphoproliferative disorder was observed (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.009). The PTLD mortality was 5%. There was a change in the PCR level after tacrolimus reduction (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.002) and after tacrolimus exchange for mTOR (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.008). The number of EBV copies was significantly higher (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.029) in patients who developed PTLD. In the multiple regression model, seropositivity for CMV was an independent protective factor for lymphoproliferative disorder (OR=0.09; 95% CI 0.02\u20130.42), reducing the chance of having PTLD adjusted by serology for EBV by 91%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Monitoring the EBV viral load by PCR seems to prevent the emergence of milder forms of lymphoproliferative disorder. Pretransplant seropositivity for CMV is a protective factor for PTLD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14226","type":"journal-article","created":{"date-parts":[[2022,1,17]],"date-time":"2022-01-17T09:08:05Z","timestamp":1642410485000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Seropositivity for cytomegalovirus and PCR\u2010EBV monitoring: Protective factors for posttransplant lymphoproliferative disorder in pediatric liver transplant"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6821-6658","authenticated-orcid":false,"given":"L\u00edgia Patr\u00edcia de Carvalho Batista","family":"\u00c9boli","sequence":"first","affiliation":[{"name":"Faculdade de Medicina da Universidade de S\u00e3o Paulo Hospital Universit\u00e1rio Oswaldo Cruz  Pernambuco 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