{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T07:55:33Z","timestamp":1793778933147,"version":"4.6.1"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T00:00:00Z","timestamp":1714348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UO1 AI104342"],"award-info":[{"award-number":["UO1 AI104342"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Epstein\u2013Barr virus (EBV)\u2010associated post\u2010transplant lymphoproliferative disorders (PTLD) is the most common malignancy in children after transplant; however, difficulties for early detection may worsen the prognosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The prospective, multicenter, study enrolled 944 children (\u226421\u2009years of age). Of these, 872 received liver, heart, kidney, intestinal, or multivisceral transplants in seven US centers between 2014 and 2019 (NCT02182986). In total, 34 pediatric EBV+ PTLD (3.9%) were identified by biopsy. Variables included sex, age, race, ethnicity, transplanted organ, EBV viral load, pre\u2010transplant EBV serology, immunosuppression, response to chemotherapy and rituximab, and histopathological diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The uni\u2212\/multivariable competing risk analyses revealed the combination of EBV\u2010seropositive donor and EBV\u2010na\u00efve recipient (D+R\u2212) was a significant risk factor for PTLD development (sub\u2010hazard ratio: 2.79 [1.34\u20135.78], <jats:italic>p<\/jats:italic>\u2009=\u2009.006) and EBV DNAemia (2.65 [1.72\u20134.09], <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Patients with D+R\u2212 were significantly more associated with monomorphic\/polymorphic PTLD than those with the other combinations (<jats:italic>p<\/jats:italic>\u2009=\u2009.02). Patients with monomorphic\/polymorphic PTLD (<jats:italic>n<\/jats:italic>\u2009=\u200921) had significantly more EBV DNAemia than non\u2010PTLD patients (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and an earlier clinical presentation of PTLD than patients with hyperplasias (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), within 6\u2010month post\u2010transplant. Among non\u2010liver transplant recipients, monomorphic\/polymorphic PTLD were significantly more frequent than hyperplasias in patients \u22655\u2009years of age at transplant (<jats:italic>p<\/jats:italic>\u2009=\u2009.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>D+R\u2212 is a risk factor for PTLD and EBV DNAemia and associated with the incidence of monomorphic\/polymorphic PTLD. Intensive follow\u2010up of EBV viral load within 6\u2010month post\u2010transplant, especially for patients with D+R\u2212 and\/or non\u2010liver transplant recipients \u22655\u2009years of age at transplant, may help detect monomorphic\/polymorphic PTLD early in pediatric transplant.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14763","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T11:23:29Z","timestamp":1714389809000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Epstein\u2013Barr virus\u2010associated post\u2010transplant lymphoproliferative disorders in pediatric transplantation: A prospective multicenter study in the United States"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6538-7408","authenticated-orcid":false,"given":"Tetsuya","family":"Tajima","sequence":"first","affiliation":[{"name":"Division of Abdominal Transplantation, 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9182-8123","authenticated-orcid":false,"given":"Dita","family":"Gratzinger","sequence":"additional","affiliation":[{"name":"Department of Pathology Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant","family":"Lum","sequence":"additional","affiliation":[{"name":"Division of Abdominal Transplantation, Department of Surgery Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunari","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Division of Abdominal Transplantation, Department of Surgery Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Pathology Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare J.","family":"Twist","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Roswell Park Comprehensive Cancer Center  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Weinberg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Rho Federal Systems Division, Rho  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dev M.","family":"Desai","sequence":"additional","affiliation":[{"name":"Division of Surgical Transplantation University of Texas (UT) Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2624-8632","authenticated-orcid":false,"given":"George V.","family":"Mazariegos","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Pittsburgh Medical Center (UPMC) Children's Hospital  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifford","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Cincinnati Children's Hospital University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas M.","family":"Fishbein","sequence":"additional","affiliation":[{"name":"Department of Surgery and Pediatrics MedStar Georgetown University Hospital  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akin","family":"Tekin","sequence":"additional","affiliation":[{"name":"Department of Surgery 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