{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T11:30:58Z","timestamp":1776771058788,"version":"3.51.2"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontierspartnerships.org"],"crossmark-restriction":true},"short-container-title":["Transpl. Int."],"abstract":"<jats:p>Post-transplant lymphoproliferative disorder (PTLD) is a major complication of solid organ transplantation (SOT), with the greatest risk in Epstein\u2013Barr virus (EBV) donor-positive\/recipient-negative (D+\/R\u2212) pairs. The contribution of cytomegalovirus (CMV) serostatus is less well defined. We conducted a population-based study of 47,333 abdominal SOT recipients in the United States (1995\u20132015) using linked SRTR data. Donor\u2013recipient EBV\/CMV serostatus was evaluated as a compound variable. The primary outcome was PTLD incidence, with secondary analyses assessing predictors of PTLD and impact on survival. Overall, 716 patients (1.5%) developed PTLD at a median of 6.1 years (IQR 2.9\u20139.7) after transplant. EBV D+\/R- recipients had the highest incidence (3.2%), and those with compound [EBV D+\/R\u2212, CMV D\u2212\/R\u2212] serostatus had more than double the PTLD risk compared with [EBV D+\/R\u2212, CMV D+\/R\u2212] (5.3% vs. 2.5%, p &amp;lt; 0.001). Logistic regression and random forest models consistently identified [EBV D+\/R\u2212, CMV D-\/R-] serostatus, age, and race as leading predictors, though discrimination was modest (test AUC \u223c0.61). In a matched survival analysis, PTLD was not associated with increased all-cause mortality (aHR \u223c1.0). Our findings demonstrate that combined EBV\/CMV serostatus improves PTLD risk prediction compared with EBV alone and emphasize the need for targeted preventive strategies.<\/jats:p>","DOI":"10.3389\/ti.2026.15781","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T14:41:32Z","timestamp":1770820892000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Machine Learning\u2013Based Evaluation of Combined EBV and CMV Serostatus as Predictors of Post-Transplant Lymphoproliferative Disorder"],"prefix":"10.3389","volume":"39","author":[{"given":"Ghazal","family":"Azarfar","sequence":"first","affiliation":[{"name":"Ajmera Transplant Centre, University Health Network","place":["Toronto, ON, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muath A. 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