{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T01:02:43Z","timestamp":1788397363933,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,5,7]],"date-time":"2018-05-07T00:00:00Z","timestamp":1525651200000},"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":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2018,8]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Serial monitoring of Epstein\u2010Barr virus (EBV<\/jats:styled-content>) reveals that certain pediatric liver transplant (LT<\/jats:styled-content>) recipients exhibit high EBV<\/jats:styled-content> loads for long periods. We investigated the incidence and risk factors of chronic high EBV<\/jats:styled-content> (CHEBV<\/jats:styled-content>) loads (continuous EBV DNA<\/jats:styled-content> >10\u00a0000\u00a0IU<\/jats:styled-content>\/mL<\/jats:styled-content> of whole blood for \u22656\u00a0months) and long\u2010term outcomes.<\/jats:p><\/jats:sec>Methods<\/jats:title>This single center, retrospective observational study investigated pediatric LT<\/jats:styled-content> recipients who survived \u22656\u00a0months. We quantitated EBV DNA<\/jats:styled-content> weekly during hospitalization and subsequently every 4 or 6\u00a0weeks at the outpatient clinic. Tacrolimus was maintained at a low trough level (<3\u00a0ng\/mL, EBV DNA<\/jats:styled-content> load >5000\u00a0IU<\/jats:styled-content>\/mL<\/jats:styled-content>).<\/jats:p><\/jats:sec>Results<\/jats:title>Thirty\u2010one of 77 LT<\/jats:styled-content> recipients developed CHEBV<\/jats:styled-content>. Univariate analysis revealed that age <2\u00a0years and body weight <10\u00a0kg upon LT<\/jats:styled-content>, operation time <700\u00a0minutes, warm ischemia time (WIT<\/jats:styled-content>) >35\u00a0minutes, graft\u2010to\u2010recipient weight ratio (GRWR<\/jats:styled-content>) >2.7%, and preoperative EBV<\/jats:styled-content> seronegativity were significantly associated with the development of CHEBV<\/jats:styled-content> loads. Multivariate analysis identified significant associations of CHEBV<\/jats:styled-content> with WIT<\/jats:styled-content> >35\u00a0minutes, GRWR<\/jats:styled-content> >2.7%, and preoperative seronegative. None of the recipients developed post\u2010transplantation lymphoproliferative disorder. Survival rates of patients with and without CHEBV<\/jats:styled-content> loads were not significantly different.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>A significant number of pediatric LT<\/jats:styled-content> recipients developed CHEBV<\/jats:styled-content> loads. Long WIT<\/jats:styled-content>, high GRWR<\/jats:styled-content>, and preoperative EBV<\/jats:styled-content> seronegativity were significantly associated with the development of CHEBV<\/jats:styled-content> loads. Although the long\u2010term outcomes of patients with or without CHEBV<\/jats:styled-content> loads were not significantly different, further studies of more subjects are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12911","type":"journal-article","created":{"date-parts":[[2018,4,20]],"date-time":"2018-04-20T16:12:32Z","timestamp":1524240752000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Risk factors and long\u2010term outcomes of pediatric liver transplant recipients with chronic high Epstein\u2010Barr virus loads"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8299-3613","authenticated-orcid":false,"given":"Hideya","family":"Kamei","sequence":"first","affiliation":[{"name":"Departments of Transplantation Surgery Nagoya University Hospital Showa Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Nagoya University Graduate School of Medicine Showa Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichi","family":"Kawada","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Nagoya University Graduate School of Medicine Showa Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Ogiso","sequence":"additional","affiliation":[{"name":"Departments of Transplantation Surgery Nagoya University Hospital Showa Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuharu","family":"Onishi","sequence":"additional","affiliation":[{"name":"Departments of Transplantation Surgery Nagoya University Hospital Showa Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Komagome","sequence":"additional","affiliation":[{"name":"Departments of Transplantation Surgery Nagoya University Hospital Showa Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiko","family":"Kurata","sequence":"additional","affiliation":[{"name":"Departments of Transplantation Surgery Nagoya University Hospital Showa Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Ogura","sequence":"additional","affiliation":[{"name":"Departments of Transplantation Surgery Nagoya University Hospital Showa Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3046.2001.00021.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199502270-00015"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000057244.03192.BD"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199608150-00012"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199711270-00011"},{"key":"e_1_2_9_7_1","first-page":"94","article-title":"The effect of immunosuppression on posttransplant lymphoproliferative disease in pediatric liver transplant patients","volume":"70","author":"Younes BS","year":"2000","journal-title":"Transplantation"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3046.1999.00066.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2005.01002.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200109270-00006"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/rmv.582"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2007.02080.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3046.2003.02051.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.20958"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1086\/653737"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2008.00926.x"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200207270-00009"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V98.2.280"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01515-06"},{"key":"e_1_2_9_20_1","unstructured":"FryerJF HeathAB WilkinsonDE MinorPD the collaborative study group.Collaborative study to evaluate the proposed 1st WHO international standard for Epstein\u2010Barr virus (EBV) for nucleic acid amplification technology (NAT)\u2010based assays.2011.http:\/\/apps.who.int\/iris\/handle\/10665\/70781. 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