Epstein-Barr Virus DNAemia and post-transplant lymphoproliferative disorder in pediatric solid organ transplant recipients
Pediatric solid organ transplant (SOT) recipients commonly have Epstein-Barr virus (EBV) DNAemia and are at risk of developing post-transplant lymphoproliferative disorder (PTLD). EBV DNAemia has not been analyzed on a continuous scale in this population. All children [less than or equal to] 18 year...
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| description | Pediatric solid organ transplant (SOT) recipients commonly have Epstein-Barr virus (EBV) DNAemia and are at risk of developing post-transplant lymphoproliferative disorder (PTLD). EBV DNAemia has not been analyzed on a continuous scale in this population. All children [less than or equal to] 18 years of age who underwent SOT at a single center between January 1, 2007 and July 31, 2018 were included in this retrospective study. Transplant episodes in which PTLD occurred were compared to transplant episodes without PTLD. Multivariable logistic regression was used to identify factors associated with the development of EBV DNAemia and maximum height of EBV DNAemia. A Cox proportional hazards model was used to calculate hazard ratios for time to PTLD. Of 275 total transplant recipients and 294 transplant episodes, there were 14 episodes of PTLD. Intestinal and multivisceral transplant were strongly associated with PTLD (p = 0.002). Risk factors for the development of EBV DNAemia include donor and recipient positive EBV serologies (p = 0.001) and older age (p = 0.001). Maximum level of EBV DNAemia was significantly associated with development of PTLD (p |
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EBV DNAemia has not been analyzed on a continuous scale in this population. All children [less than or equal to] 18 years of age who underwent SOT at a single center between January 1, 2007 and July 31, 2018 were included in this retrospective study. Transplant episodes in which PTLD occurred were compared to transplant episodes without PTLD. Multivariable logistic regression was used to identify factors associated with the development of EBV DNAemia and maximum height of EBV DNAemia. A Cox proportional hazards model was used to calculate hazard ratios for time to PTLD. Of 275 total transplant recipients and 294 transplant episodes, there were 14 episodes of PTLD. Intestinal and multivisceral transplant were strongly associated with PTLD (p = 0.002). Risk factors for the development of EBV DNAemia include donor and recipient positive EBV serologies (p = 0.001) and older age (p = 0.001). Maximum level of EBV DNAemia was significantly associated with development of PTLD (p<0.0001). Every one log (log.sub.10) increase in the maximum level of EBV DNAemia was associated with a more than doubling of the hazard on developing PTLD (HR: 2.18, 95% CI 1.19-3.99). Transplant type was strongly associated with development of PTLD in pediatric SOT recipients. EBV serologies and age were associated with the development of EBV DNAemia and height of DNAemia. High levels of EBV DNAemia were strongly associated with an increased hazard for PTLD.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0269766</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Age ; Biology and life sciences ; Complications and side effects ; Diagnosis ; Electronic health records ; Epstein-Barr virus ; Genetic aspects ; Health risks ; Heart ; Infections ; Laboratories ; Liver ; Liver transplants ; Lymphatic diseases ; Lymphocytes ; Lymphoproliferative disorders ; Medicine and Health Sciences ; Patients ; Pediatrics ; Posttransplant lymphoproliferative disorders ; Risk analysis ; Risk factors ; Statistical models ; Transplantation of organs, tissues, etc ; Transplants & implants ; Viruses</subject><ispartof>PloS one, 2022-10, Vol.17 (10), p.e0269766-e0269766</ispartof><rights>COPYRIGHT 2022 Public Library of Science</rights><rights>2022 Chang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 Chang et al 2022 Chang et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c599t-decdf345819c4f142181ea021570639435ebda3e3fd6a37cc5792d870ccf34e83</citedby><cites>FETCH-LOGICAL-c599t-decdf345819c4f142181ea021570639435ebda3e3fd6a37cc5792d870ccf34e83</cites><orcidid>0000-0003-3073-4980 ; 0000-0002-5694-5308 ; 0000-0001-9387-9517</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9578615/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9578615/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23847,27903,27904,53769,53771,79346,79347</link.rule.ids></links><search><contributor>Gołębiewska, Justyna</contributor><creatorcontrib>Chang, Yeh-Chung</creatorcontrib><creatorcontrib>Young, Rebecca R</creatorcontrib><creatorcontrib>Mavis, Alisha M</creatorcontrib><creatorcontrib>Chambers, Eileen T</creatorcontrib><creatorcontrib>Kirmani, Sonya</creatorcontrib><creatorcontrib>Kelly, Matthew S</creatorcontrib><creatorcontrib>Kalu, Ibukunoluwa C</creatorcontrib><creatorcontrib>Smith, Michael J</creatorcontrib><creatorcontrib>Lugo, Debra J</creatorcontrib><title>Epstein-Barr Virus DNAemia and post-transplant lymphoproliferative disorder in pediatric solid organ transplant recipients</title><title>PloS one</title><description>Pediatric solid organ transplant (SOT) recipients commonly have Epstein-Barr virus (EBV) DNAemia and are at risk of developing post-transplant lymphoproliferative disorder (PTLD). EBV DNAemia has not been analyzed on a continuous scale in this population. All children [less than or equal to] 18 years of age who underwent SOT at a single center between January 1, 2007 and July 31, 2018 were included in this retrospective study. Transplant episodes in which PTLD occurred were compared to transplant episodes without PTLD. Multivariable logistic regression was used to identify factors associated with the development of EBV DNAemia and maximum height of EBV DNAemia. A Cox proportional hazards model was used to calculate hazard ratios for time to PTLD. Of 275 total transplant recipients and 294 transplant episodes, there were 14 episodes of PTLD. Intestinal and multivisceral transplant were strongly associated with PTLD (p = 0.002). Risk factors for the development of EBV DNAemia include donor and recipient positive EBV serologies (p = 0.001) and older age (p = 0.001). Maximum level of EBV DNAemia was significantly associated with development of PTLD (p<0.0001). Every one log (log.sub.10) increase in the maximum level of EBV DNAemia was associated with a more than doubling of the hazard on developing PTLD (HR: 2.18, 95% CI 1.19-3.99). Transplant type was strongly associated with development of PTLD in pediatric SOT recipients. EBV serologies and age were associated with the development of EBV DNAemia and height of DNAemia. High levels of EBV DNAemia were strongly associated with an increased hazard for PTLD.</description><subject>Age</subject><subject>Biology and life sciences</subject><subject>Complications and side effects</subject><subject>Diagnosis</subject><subject>Electronic health records</subject><subject>Epstein-Barr virus</subject><subject>Genetic aspects</subject><subject>Health risks</subject><subject>Heart</subject><subject>Infections</subject><subject>Laboratories</subject><subject>Liver</subject><subject>Liver transplants</subject><subject>Lymphatic diseases</subject><subject>Lymphocytes</subject><subject>Lymphoproliferative disorders</subject><subject>Medicine and Health Sciences</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Posttransplant lymphoproliferative disorders</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Statistical models</subject><subject>Transplantation of organs, tissues, etc</subject><subject>Transplants & 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Virus DNAemia and post-transplant lymphoproliferative disorder in pediatric solid organ transplant recipients</title><author>Chang, Yeh-Chung ; Young, Rebecca R ; Mavis, Alisha M ; Chambers, Eileen T ; Kirmani, Sonya ; Kelly, Matthew S ; Kalu, Ibukunoluwa C ; Smith, Michael J ; Lugo, Debra J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c599t-decdf345819c4f142181ea021570639435ebda3e3fd6a37cc5792d870ccf34e83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Age</topic><topic>Biology and life sciences</topic><topic>Complications and side effects</topic><topic>Diagnosis</topic><topic>Electronic health records</topic><topic>Epstein-Barr virus</topic><topic>Genetic aspects</topic><topic>Health risks</topic><topic>Heart</topic><topic>Infections</topic><topic>Laboratories</topic><topic>Liver</topic><topic>Liver transplants</topic><topic>Lymphatic 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one</jtitle><date>2022-10-18</date><risdate>2022</risdate><volume>17</volume><issue>10</issue><spage>e0269766</spage><epage>e0269766</epage><pages>e0269766-e0269766</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Pediatric solid organ transplant (SOT) recipients commonly have Epstein-Barr virus (EBV) DNAemia and are at risk of developing post-transplant lymphoproliferative disorder (PTLD). EBV DNAemia has not been analyzed on a continuous scale in this population. All children [less than or equal to] 18 years of age who underwent SOT at a single center between January 1, 2007 and July 31, 2018 were included in this retrospective study. Transplant episodes in which PTLD occurred were compared to transplant episodes without PTLD. Multivariable logistic regression was used to identify factors associated with the development of EBV DNAemia and maximum height of EBV DNAemia. A Cox proportional hazards model was used to calculate hazard ratios for time to PTLD. Of 275 total transplant recipients and 294 transplant episodes, there were 14 episodes of PTLD. Intestinal and multivisceral transplant were strongly associated with PTLD (p = 0.002). Risk factors for the development of EBV DNAemia include donor and recipient positive EBV serologies (p = 0.001) and older age (p = 0.001). Maximum level of EBV DNAemia was significantly associated with development of PTLD (p<0.0001). Every one log (log.sub.10) increase in the maximum level of EBV DNAemia was associated with a more than doubling of the hazard on developing PTLD (HR: 2.18, 95% CI 1.19-3.99). Transplant type was strongly associated with development of PTLD in pediatric SOT recipients. EBV serologies and age were associated with the development of EBV DNAemia and height of DNAemia. High levels of EBV DNAemia were strongly associated with an increased hazard for PTLD.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><doi>10.1371/journal.pone.0269766</doi><tpages>e0269766</tpages><orcidid>https://orcid.org/0000-0003-3073-4980</orcidid><orcidid>https://orcid.org/0000-0002-5694-5308</orcidid><orcidid>https://orcid.org/0000-0001-9387-9517</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Age Biology and life sciences Complications and side effects Diagnosis Electronic health records Epstein-Barr virus Genetic aspects Health risks Heart Infections Laboratories Liver Liver transplants Lymphatic diseases Lymphocytes Lymphoproliferative disorders Medicine and Health Sciences Patients Pediatrics Posttransplant lymphoproliferative disorders Risk analysis Risk factors Statistical models Transplantation of organs, tissues, etc Transplants & implants Viruses |
| title | Epstein-Barr Virus DNAemia and post-transplant lymphoproliferative disorder in pediatric solid organ transplant recipients |
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