{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T22:52:35Z","timestamp":1775947955338,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prior studies and guidelines emphasize PTLD\u2010risk for Epstein\u2013Barr virus (EBV) mismatched (D+\/R\u2212) recipients. However, risk among D\u2212\/R\u2212 kidney recipients remains poorly defined. We evaluated PTLD\u2010risk by donor\u2013recipient EBV serostatus, including D\u2212\/R\u2212, and time\u2010varying impact of PTLD on mortality in kidney transplant recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort included deceased donor kidney transplants from the US Scientific Registry of Transplant Recipients (2003\u20132023). Recipient and donor\u2010recipient EBV serostatus were categorical exposures. Time\u2010to\u2010PTLD was analyzed using Kaplan\u2013Meier methods and adjusted Cox models, stratified into 0\u20131, 1\u20132, and 2\u20133 years to address non\u2010proportional hazards. Secondary outcomes included mortality and all\u2010cause graft failure (ACGF), with PTLD modeled as a time\u2010dependent exposure. Effect modification across key subgroups was evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 309\u00a0585 recipients (2.35 million person\u2010years), 3147 PTLD events (1.1%) occurred, largely within the first year. Incidence was highest for D+\/R\u2212 (3%) and D\u2212\/R\u2212 (1.8%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). First\u2010year PTLD\u2010risk was highest for D+\/R\u2212 (HR 17.8 [95% CI: 10.4, 30.5]) and D\u2212\/R\u2212 (HR 8.2 [95% CI: 4.2, 15.8]) recipients. PTLD was associated with increased mortality (HR 4.5 [95% CI: 4.3, 4.8]) and ACGF (HR 3.7 [95% CI: 3.5, 3.9]), with relatively higher mortality\u2010risk for pediatric recipients (ratio of HRs 1.5). Among 82 detailed PTLD cases, most were B\u2010cell (89%), monoclonal (63%), and EBV\u2010positive (78%), with mixed WHO class and site\u2010involvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      EBV D+\/R\u2212 recipients experienced highest and sustained 3\u2010year PTLD\u2010risk, while D\u2212\/R\u2212 recipients faced previously under\u2010recognized early risk. PTLD was strongly linked to mortality and ACGF, refining counselling and supporting targeted surveillance for high\u2010risk groups.\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid70165-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.70165","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T18:07:57Z","timestamp":1768846077000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Donor\u2013Recipient Epstein\u2013Barr Virus Serostatus and Time\u2010Varying Risk of Posttransplant Lymphoproliferative Disorder in Kidney Transplant Recipients"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8040-7908","authenticated-orcid":false,"given":"Christie","family":"Rampersad","sequence":"first","affiliation":[{"name":"Ajmera Transplant Centre Toronto General Hospital University Health Network  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7979-2458","authenticated-orcid":false,"given":"Seyed M.","family":"Hosseini\u2010Moghaddam","sequence":"additional","affiliation":[{"name":"Ajmera Transplant Centre Toronto General Hospital University Health Network  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5021-9831","authenticated-orcid":false,"given":"S. Joseph","family":"Kim","sequence":"additional","affiliation":[{"name":"Ajmera Transplant Centre Toronto General Hospital University Health Network  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181b9692d"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfr769"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2011.03896.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2011.03893.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2011.07.015"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002146"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21911"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102009\u201002\u2010202507"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/tri.12744"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfx356"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13652"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2005.00776.x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11899\u2010013\u20100162\u20105"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13324"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semcancer.2014.04.004"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1086\/379834"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2025.01.035"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2008.02167.x"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.7326\/ANNALS\u201024\u201000165"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.70117"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12990"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.10312"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2018.06.009"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2024.02.028"},{"key":"e_1_2_10_26_1","doi-asserted-by":"crossref","unstructured":"R.San\u2010Juan O.Manuel H. 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