{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T15:19:05Z","timestamp":1770909545941,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Post\u2010transplant lymphoproliferative disorders (PTLD) may significantly impair outcomes in children after solid organ transplantation (SOT). Diagnosis and treatment may be challenging. We analyze a representative pediatric liver transplant (LT) cohort in light of these challenges.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pediatric LT recipients monitored by the Swiss Pediatric Liver Center from 2009 to 2021 with a suspicion of Epstein\u2013Barr virus (EBV) driven PTLD were included. All cases were retrospectively reviewed using the World Health Organization (WHO) 2022 classification criteria for Pediatric Tumors. Two groups were defined: (1) histologically confirmed PTLD, and (2) \u2018indeterminate PTLD\u2019 if criteria were not entirely met.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the inclusion period, 111 patients underwent LT. Histology review confirmed PTLD in 13 patients (11.7%) while 3 patients were included in the \u2018indeterminate\u2019 group. The most common subtype was non\u2010destructive PTLD (6\/13), followed by monomorphic (4\/13) and polymorphic PTLD (3\/13). Hypermetabolism on whole body (<jats:sup>18<\/jats:sup>F) fluorodeoxyglucose PET\/CT helped define adequate biopsy location in 11\/13 patients. Three patients with monomorphic PTLD also showed low\u2010grade PTLD subtypes in other biopsy sites. Nine patients received mTOR inhibitors after diagnosis, either as monotherapy or in combination with calcineurin inhibitors, without major side effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The detailed analysis of our series of pediatric LT patients with PTLD allowed for the development of a diagnostic and management algorithm, now applied at our institution. Spatial and temporal heterogeneity argues in favor of multiple and, if necessary, repeated biopsies at different sites.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.70060","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:02:38Z","timestamp":1744848158000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Meeting the Challenges of Post\u2010Transplant Lymphoproliferative Disorders After Liver Transplantation in Children: A Proposed Diagnostic and Management Algorithm"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5315-9267","authenticated-orcid":false,"given":"Nathalie Marie","family":"Rock","sequence":"first","affiliation":[{"name":"Swiss Pediatric Liver Center, Department of Pediatrics, Gynecology, and Obstetrics Geneva University Hospitals and University of Geneva  Geneva Switzerland"},{"name":"Pediatric Gastroenterology, Hepatology, and Nutrition Unit, Division of Pediatric Subspecialities, Department of Pediatrics, Gynecology, and Obstetrics,Department of Pediatrics, Gynecology and Obstetrics University of Geneva  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3927-9446","authenticated-orcid":false,"given":"Antonin","family":"Bouroumeau","sequence":"additional","affiliation":[{"name":"Division of Clinical Pathology Geneva University Hospitals  Geneva Switzerland"},{"name":"Institute of Pathology, Viollier Gen\u00e8ve SA  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5039-4720","authenticated-orcid":false,"given":"Danai","family":"Papangelopoulou","sequence":"additional","affiliation":[{"name":"Division of Pediatric Oncology and Hematology, Department of Women, Child, and Adolescent Geneva University Hospitals  Geneva Switzerland"},{"name":"Cansearch Research Platform for Pediatric Oncology and Hematology, Department of Pediatrics, Gynecology, and Obstetrics, Faculty of Medicine University of Geneva  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5296-0116","authenticated-orcid":false,"given":"Ismini","family":"Mainta","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine Geneva University Hospitals  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7011-1448","authenticated-orcid":false,"given":"Eirini","family":"Katirtzidou","sequence":"additional","affiliation":[{"name":"Swiss Pediatric Liver Center, Department of Pediatrics, Gynecology, and Obstetrics Geneva University Hospitals and University of Geneva  Geneva Switzerland"},{"name":"Unit of Pediatric Radiology, Division of Radiology Geneva University Hospitals  Geneva 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Gynecology, and Obstetrics Geneva University Hospitals and University of Geneva  Geneva Switzerland"},{"name":"Division of Pediatric Infectious Disease, Department of Women, Child, and Adolescent Geneva University Hospitals  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9649-6498","authenticated-orcid":false,"given":"Marc","family":"Ansari","sequence":"additional","affiliation":[{"name":"Division of Pediatric Oncology and Hematology, Department of Women, Child, and Adolescent Geneva University Hospitals  Geneva Switzerland"},{"name":"Cansearch Research Platform for Pediatric Oncology and Hematology, Department of Pediatrics, Gynecology, and Obstetrics, Faculty of Medicine University of Geneva  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0711-687X","authenticated-orcid":false,"given":"Val\u00e9rie Anne","family":"McLin","sequence":"additional","affiliation":[{"name":"Swiss Pediatric Liver Center, Department of Pediatrics, Gynecology, and Obstetrics Geneva University Hospitals and University of Geneva  Geneva Switzerland"},{"name":"Pediatric Gastroenterology, Hepatology, and Nutrition Unit, Division of Pediatric Subspecialities, Department of Pediatrics, Gynecology, and Obstetrics,Department of Pediatrics, Gynecology and Obstetrics University of Geneva  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8059-3015","authenticated-orcid":false,"given":"Frederic","family":"Baleydier","sequence":"additional","affiliation":[{"name":"Swiss Pediatric Liver Center, Department of Pediatrics, Gynecology, and Obstetrics Geneva University Hospitals and University of Geneva  Geneva Switzerland"},{"name":"Division of Pediatric Oncology and Hematology, Department of Women, Child, and Adolescent Geneva University Hospitals  Geneva 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