{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T21:17:35Z","timestamp":1790371055885,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T00:00:00Z","timestamp":1703721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Post\u2010transplant lymphoproliferative disorder (PTLD) is a clinically heterogeneous potentially fatal complication of pediatric liver transplantation (PLT). We determined the prevalence, complications, and associated factors for PTLD in PLT recipients from Wits Donald Gordon Medical Centre, South Africa from January 2012 to August 2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective record review of 150 PLT recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Histologically proven PTLD occurred in 17\/150 PLT recipients (11.3%). Children with PTLD were significantly younger at transplant (17.9 vs. 32.7 months, <jats:italic>p<\/jats:italic> = 0.001) with a significantly higher prevalence of obstructive etiology (17\/17 vs. 81\/133, <jats:italic>p<\/jats:italic> = 0.001). Fifteen (88.2%) children with PTLD were Epstein\u2010Barr virus (EBV) seronegative at transplant. High post\u2010transplant EBV viral load at a threshold value of 4.8 log<jats:sub>10<\/jats:sub> DNA copies\/mL (sensitivity: 80.0% [95% confidence interval {CI}, 46.7%\u2013100.0%]; specificity: 73.1% [95% CI 42.3%\u201393.3%; area under the curve {AUC} 75.8%]) and low post\u2010transplant albumin levels at a threshold value of 21.5\u00a0g\/L (sensitivity: 70.6% [95% CI, 41.2%\u201394.1%]; specificity: 85.7% [95% CI, 60.4%\u201394.5%; {AUC} 74.8%]) were associated with PTLD. The prevalence of cytomegalovirus (CMV) disease was significantly higher in children who developed PTLD versus non\u2010PTLD (12\/17 vs. 18\/133; <jats:italic>p<\/jats:italic> &lt; 0.001). CMV disease and the combination of post\u2010transplant high EBV viral load and low albumin were independently associated with an increased risk of developing PTLD. Four (23.5%) children with PTLD died, however, survival was equivalent to non\u2010PTLD PLT (<jats:italic>p<\/jats:italic> = 0.580).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The prevalence of PTLD in our cohort mirrors international cohorts, with mortality similar to non\u2010PTLD PLT recipients.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid14221-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.14221","type":"journal-article","created":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T08:19:46Z","timestamp":1703751586000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Post\u2010transplant lymphoproliferative disorder in pediatric liver transplant recipients: Experience from a South African transplant center"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4584-5958","authenticated-orcid":false,"given":"Priya","family":"Walabh","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Child Health School of Clinical Medicine Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"},{"name":"Paediatric Gastroenterology and Hepatology Unit Charlotte Maxeke Johannesburg Hospital University of Witwatersrand  Johannesburg South Africa"},{"name":"Gauteng Provincial Solid Organ Transplant Division  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health School of Clinical Medicine Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"},{"name":"Department of Paediatrics and Child Health Chris Hani Baragwanath Academic Hospital University of Witwatersrand  Johannesburg South Africa"},{"name":"Medical Research Council: Vaccines and Infectious Diseases Analytics (VIDA) Research Unit Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Hajinicolaou","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health School of Clinical Medicine Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"},{"name":"Department of Paediatrics and Child Health Chris Hani Baragwanath Academic Hospital University of Witwatersrand  Johannesburg South Africa"},{"name":"Department of Paediatrics and Child Health University of Witwatersrand  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,28]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.26034"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/TRRM.S84744"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12004"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11899\u2010013\u20100162\u20105"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/814973"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11082166"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/TXD.0000000000000557"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e318277e344"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.3345\/kjp.2017.60.3.86"},{"key":"e_1_2_13_11_1","doi-asserted-by":"crossref","unstructured":"WalabhP MooreDP PagetG et\u00a0al.Healthcare disparity and its associations with cytomegalovirus disease in pediatric liver transplant recipients in South Africa.2022;(June):1\u201011. doi:10.1111\/tid.13917","DOI":"10.1111\/tid.13917"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1086\/466529"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beha.2023.101446"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14235949"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14020"},{"key":"e_1_2_13_16_1","unstructured":"R Core Team.R: A language and environment for statistical computing. 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