Clinical Utility of Epstein-Barr Virus Viral Load Monitoring and Risk Factors for Posttransplant Lymphoproliferative Disorders After Kidney Transplantation: A Single-Center, 10-Year Observational Cohort Study

Background. Posttransplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality in solid organ transplants. Epstein Barr virus (EBV) plays a major role in PTLD development. Guidelines recommend EBV viral load (VL) monitoring in high-risk populations in the first year....
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Autor*in:	Erica Franceschini, MD [verfasserIn] Jessica Plessi, MD [verfasserIn] Stefano Zona, MD [verfasserIn] Antonella Santoro, MD [verfasserIn] Margherita Digaetano, MD [verfasserIn] Francesco Fontana, MD [verfasserIn] Gaetano Alfano, MD [verfasserIn] Giovanni Guaraldi, MD [verfasserIn] Patrizia Comoli, MD [verfasserIn] Francesca Facchini, MD [verfasserIn] Leonardo Potenza, MD, PhD [verfasserIn] William Gennari, MD [verfasserIn] Mauro Codeluppi, MD [verfasserIn] Mario Luppi, MD, PhD [verfasserIn] Gianni Cappelli, MD [verfasserIn] Inge C. Gyssens, MD, PhD [verfasserIn] Cristina Mussini, MD [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2017

Übergeordnetes Werk:	In: Transplantation Direct - Wolters Kluwer, 2017, 3(2017), 7, p e182
Übergeordnetes Werk:	volume:3 ; year:2017 ; number:7, p e182

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1097/TXD.0000000000000703

Katalog-ID:	DOAJ011962062

Internformat


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520			\|a Background. Posttransplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality in solid organ transplants. Epstein Barr virus (EBV) plays a major role in PTLD development. Guidelines recommend EBV viral load (VL) monitoring in high-risk populations in the first year. Methods. Retrospective observational study in all adult patients who had at least 1 EBV-VL performed in the postkidney transplant (KT) period from January 2005 to December 2014 at the Policlinico Modena Hospital. We compared patients with negative EBV-DNA to patients with positive EBV-DNA and we described PTLD developed in the study period. Results. One hundred ninety (36.3%) KT patients of 523 were screened for EBV-DNA with 796 samples. One hundred twenty-eight (67.4%) of 190 tested patients presented at least 1 positive sample for EBV. Older age, the use of sirolimus, everolimus, and steroids were associated with EBV-DNA positivity in the univariate analysis. Nine (1.7%) of 523 patients had PTLD. Incidence rate of PTLD in the KT cohort was 0.19/100 person year follow-up (95% confidence interval, 0.09-0.37). One of 9 patients developed early PTLD and was a high-risk patient. Only this PTLD case was positive for EBV. No PTLD case had an EBV-VL superior to 4000 copies/mL. Conclusions. Our results suggest that the keystone of PTLD diagnosis is the clinical suspicion. Our study suggests that, in line with guidelines, EBV-VL assays may be avoided in low-risk patients in the absence of a strong clinical PTLD suspicion without increasing patients' risk of developing PTLD. This represents a safe and cost-saving clinical strategy for our center.
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700	0		\|a Stefano Zona, MD \|e verfasserin \|4 aut
700	0		\|a Antonella Santoro, MD \|e verfasserin \|4 aut
700	0		\|a Margherita Digaetano, MD \|e verfasserin \|4 aut
700	0		\|a Francesco Fontana, MD \|e verfasserin \|4 aut
700	0		\|a Gaetano Alfano, MD \|e verfasserin \|4 aut
700	0		\|a Giovanni Guaraldi, MD \|e verfasserin \|4 aut
700	0		\|a Patrizia Comoli, MD \|e verfasserin \|4 aut
700	0		\|a Francesca Facchini, MD \|e verfasserin \|4 aut
700	0		\|a Leonardo Potenza, MD, PhD \|e verfasserin \|4 aut
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700	0		\|a Mauro Codeluppi, MD \|e verfasserin \|4 aut
700	0		\|a Mario Luppi, MD, PhD \|e verfasserin \|4 aut
700	0		\|a Gianni Cappelli, MD \|e verfasserin \|4 aut
700	0		\|a Inge C. Gyssens, MD, PhD \|e verfasserin \|4 aut
700	0		\|a Cristina Mussini, MD \|e verfasserin \|4 aut
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allfields	10.1097/TXD.0000000000000703 doi (DE-627)DOAJ011962062 (DE-599)DOAJ1f6103a933bd4ee2a3410deb9d051090 DE-627 ger DE-627 rakwb eng RD1-811 Erica Franceschini, MD verfasserin aut Clinical Utility of Epstein-Barr Virus Viral Load Monitoring and Risk Factors for Posttransplant Lymphoproliferative Disorders After Kidney Transplantation: A Single-Center, 10-Year Observational Cohort Study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background. Posttransplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality in solid organ transplants. Epstein Barr virus (EBV) plays a major role in PTLD development. Guidelines recommend EBV viral load (VL) monitoring in high-risk populations in the first year. Methods. Retrospective observational study in all adult patients who had at least 1 EBV-VL performed in the postkidney transplant (KT) period from January 2005 to December 2014 at the Policlinico Modena Hospital. We compared patients with negative EBV-DNA to patients with positive EBV-DNA and we described PTLD developed in the study period. Results. One hundred ninety (36.3%) KT patients of 523 were screened for EBV-DNA with 796 samples. One hundred twenty-eight (67.4%) of 190 tested patients presented at least 1 positive sample for EBV. Older age, the use of sirolimus, everolimus, and steroids were associated with EBV-DNA positivity in the univariate analysis. Nine (1.7%) of 523 patients had PTLD. Incidence rate of PTLD in the KT cohort was 0.19/100 person year follow-up (95% confidence interval, 0.09-0.37). One of 9 patients developed early PTLD and was a high-risk patient. Only this PTLD case was positive for EBV. No PTLD case had an EBV-VL superior to 4000 copies/mL. Conclusions. Our results suggest that the keystone of PTLD diagnosis is the clinical suspicion. Our study suggests that, in line with guidelines, EBV-VL assays may be avoided in low-risk patients in the absence of a strong clinical PTLD suspicion without increasing patients' risk of developing PTLD. This represents a safe and cost-saving clinical strategy for our center. Surgery Jessica Plessi, MD verfasserin aut Stefano Zona, MD verfasserin aut Antonella Santoro, MD verfasserin aut Margherita Digaetano, MD verfasserin aut Francesco Fontana, MD verfasserin aut Gaetano Alfano, MD verfasserin aut Giovanni Guaraldi, MD verfasserin aut Patrizia Comoli, MD verfasserin aut Francesca Facchini, MD verfasserin aut Leonardo Potenza, MD, PhD verfasserin aut William Gennari, MD verfasserin aut Mauro Codeluppi, MD verfasserin aut Mario Luppi, MD, PhD verfasserin aut Gianni Cappelli, MD verfasserin aut Inge C. Gyssens, MD, PhD verfasserin aut Cristina Mussini, MD verfasserin aut In Transplantation Direct Wolters Kluwer, 2017 3(2017), 7, p e182 (DE-627)883765349 (DE-600)2890276-2 23738731 nnns volume:3 year:2017 number:7, p e182 https://doi.org/10.1097/TXD.0000000000000703 kostenfrei https://doaj.org/article/1f6103a933bd4ee2a3410deb9d051090 kostenfrei http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000703 kostenfrei https://doaj.org/toc/2373-8731 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2039 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2068 GBV_ILN_2093 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2119 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_2446 GBV_ILN_2507 GBV_ILN_2869 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4346 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 GBV_ILN_4753 AR 3 2017 7, p e182
spelling	10.1097/TXD.0000000000000703 doi (DE-627)DOAJ011962062 (DE-599)DOAJ1f6103a933bd4ee2a3410deb9d051090 DE-627 ger DE-627 rakwb eng RD1-811 Erica Franceschini, MD verfasserin aut Clinical Utility of Epstein-Barr Virus Viral Load Monitoring and Risk Factors for Posttransplant Lymphoproliferative Disorders After Kidney Transplantation: A Single-Center, 10-Year Observational Cohort Study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background. Posttransplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality in solid organ transplants. Epstein Barr virus (EBV) plays a major role in PTLD development. Guidelines recommend EBV viral load (VL) monitoring in high-risk populations in the first year. Methods. Retrospective observational study in all adult patients who had at least 1 EBV-VL performed in the postkidney transplant (KT) period from January 2005 to December 2014 at the Policlinico Modena Hospital. We compared patients with negative EBV-DNA to patients with positive EBV-DNA and we described PTLD developed in the study period. Results. One hundred ninety (36.3%) KT patients of 523 were screened for EBV-DNA with 796 samples. One hundred twenty-eight (67.4%) of 190 tested patients presented at least 1 positive sample for EBV. Older age, the use of sirolimus, everolimus, and steroids were associated with EBV-DNA positivity in the univariate analysis. Nine (1.7%) of 523 patients had PTLD. Incidence rate of PTLD in the KT cohort was 0.19/100 person year follow-up (95% confidence interval, 0.09-0.37). One of 9 patients developed early PTLD and was a high-risk patient. Only this PTLD case was positive for EBV. No PTLD case had an EBV-VL superior to 4000 copies/mL. Conclusions. Our results suggest that the keystone of PTLD diagnosis is the clinical suspicion. Our study suggests that, in line with guidelines, EBV-VL assays may be avoided in low-risk patients in the absence of a strong clinical PTLD suspicion without increasing patients' risk of developing PTLD. This represents a safe and cost-saving clinical strategy for our center. Surgery Jessica Plessi, MD verfasserin aut Stefano Zona, MD verfasserin aut Antonella Santoro, MD verfasserin aut Margherita Digaetano, MD verfasserin aut Francesco Fontana, MD verfasserin aut Gaetano Alfano, MD verfasserin aut Giovanni Guaraldi, MD verfasserin aut Patrizia Comoli, MD verfasserin aut Francesca Facchini, MD verfasserin aut Leonardo Potenza, MD, PhD verfasserin aut William Gennari, MD verfasserin aut Mauro Codeluppi, MD verfasserin aut Mario Luppi, MD, PhD verfasserin aut Gianni Cappelli, MD verfasserin aut Inge C. Gyssens, MD, PhD verfasserin aut Cristina Mussini, MD verfasserin aut In Transplantation Direct Wolters Kluwer, 2017 3(2017), 7, p e182 (DE-627)883765349 (DE-600)2890276-2 23738731 nnns volume:3 year:2017 number:7, p e182 https://doi.org/10.1097/TXD.0000000000000703 kostenfrei https://doaj.org/article/1f6103a933bd4ee2a3410deb9d051090 kostenfrei http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000703 kostenfrei https://doaj.org/toc/2373-8731 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2039 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2068 GBV_ILN_2093 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2119 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_2446 GBV_ILN_2507 GBV_ILN_2869 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4346 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 GBV_ILN_4753 AR 3 2017 7, p e182
allfields_unstemmed	10.1097/TXD.0000000000000703 doi (DE-627)DOAJ011962062 (DE-599)DOAJ1f6103a933bd4ee2a3410deb9d051090 DE-627 ger DE-627 rakwb eng RD1-811 Erica Franceschini, MD verfasserin aut Clinical Utility of Epstein-Barr Virus Viral Load Monitoring and Risk Factors for Posttransplant Lymphoproliferative Disorders After Kidney Transplantation: A Single-Center, 10-Year Observational Cohort Study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background. Posttransplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality in solid organ transplants. Epstein Barr virus (EBV) plays a major role in PTLD development. Guidelines recommend EBV viral load (VL) monitoring in high-risk populations in the first year. Methods. Retrospective observational study in all adult patients who had at least 1 EBV-VL performed in the postkidney transplant (KT) period from January 2005 to December 2014 at the Policlinico Modena Hospital. We compared patients with negative EBV-DNA to patients with positive EBV-DNA and we described PTLD developed in the study period. Results. One hundred ninety (36.3%) KT patients of 523 were screened for EBV-DNA with 796 samples. One hundred twenty-eight (67.4%) of 190 tested patients presented at least 1 positive sample for EBV. Older age, the use of sirolimus, everolimus, and steroids were associated with EBV-DNA positivity in the univariate analysis. Nine (1.7%) of 523 patients had PTLD. Incidence rate of PTLD in the KT cohort was 0.19/100 person year follow-up (95% confidence interval, 0.09-0.37). One of 9 patients developed early PTLD and was a high-risk patient. Only this PTLD case was positive for EBV. No PTLD case had an EBV-VL superior to 4000 copies/mL. Conclusions. Our results suggest that the keystone of PTLD diagnosis is the clinical suspicion. Our study suggests that, in line with guidelines, EBV-VL assays may be avoided in low-risk patients in the absence of a strong clinical PTLD suspicion without increasing patients' risk of developing PTLD. This represents a safe and cost-saving clinical strategy for our center. Surgery Jessica Plessi, MD verfasserin aut Stefano Zona, MD verfasserin aut Antonella Santoro, MD verfasserin aut Margherita Digaetano, MD verfasserin aut Francesco Fontana, MD verfasserin aut Gaetano Alfano, MD verfasserin aut Giovanni Guaraldi, MD verfasserin aut Patrizia Comoli, MD verfasserin aut Francesca Facchini, MD verfasserin aut Leonardo Potenza, MD, PhD verfasserin aut William Gennari, MD verfasserin aut Mauro Codeluppi, MD verfasserin aut Mario Luppi, MD, PhD verfasserin aut Gianni Cappelli, MD verfasserin aut Inge C. Gyssens, MD, PhD verfasserin aut Cristina Mussini, MD verfasserin aut In Transplantation Direct Wolters Kluwer, 2017 3(2017), 7, p e182 (DE-627)883765349 (DE-600)2890276-2 23738731 nnns volume:3 year:2017 number:7, p e182 https://doi.org/10.1097/TXD.0000000000000703 kostenfrei https://doaj.org/article/1f6103a933bd4ee2a3410deb9d051090 kostenfrei http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000703 kostenfrei https://doaj.org/toc/2373-8731 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2039 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2068 GBV_ILN_2093 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2119 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_2446 GBV_ILN_2507 GBV_ILN_2869 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4346 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 GBV_ILN_4753 AR 3 2017 7, p e182
allfieldsGer	10.1097/TXD.0000000000000703 doi (DE-627)DOAJ011962062 (DE-599)DOAJ1f6103a933bd4ee2a3410deb9d051090 DE-627 ger DE-627 rakwb eng RD1-811 Erica Franceschini, MD verfasserin aut Clinical Utility of Epstein-Barr Virus Viral Load Monitoring and Risk Factors for Posttransplant Lymphoproliferative Disorders After Kidney Transplantation: A Single-Center, 10-Year Observational Cohort Study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background. Posttransplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality in solid organ transplants. Epstein Barr virus (EBV) plays a major role in PTLD development. Guidelines recommend EBV viral load (VL) monitoring in high-risk populations in the first year. Methods. Retrospective observational study in all adult patients who had at least 1 EBV-VL performed in the postkidney transplant (KT) period from January 2005 to December 2014 at the Policlinico Modena Hospital. We compared patients with negative EBV-DNA to patients with positive EBV-DNA and we described PTLD developed in the study period. Results. One hundred ninety (36.3%) KT patients of 523 were screened for EBV-DNA with 796 samples. One hundred twenty-eight (67.4%) of 190 tested patients presented at least 1 positive sample for EBV. Older age, the use of sirolimus, everolimus, and steroids were associated with EBV-DNA positivity in the univariate analysis. Nine (1.7%) of 523 patients had PTLD. Incidence rate of PTLD in the KT cohort was 0.19/100 person year follow-up (95% confidence interval, 0.09-0.37). One of 9 patients developed early PTLD and was a high-risk patient. Only this PTLD case was positive for EBV. No PTLD case had an EBV-VL superior to 4000 copies/mL. Conclusions. Our results suggest that the keystone of PTLD diagnosis is the clinical suspicion. Our study suggests that, in line with guidelines, EBV-VL assays may be avoided in low-risk patients in the absence of a strong clinical PTLD suspicion without increasing patients' risk of developing PTLD. This represents a safe and cost-saving clinical strategy for our center. Surgery Jessica Plessi, MD verfasserin aut Stefano Zona, MD verfasserin aut Antonella Santoro, MD verfasserin aut Margherita Digaetano, MD verfasserin aut Francesco Fontana, MD verfasserin aut Gaetano Alfano, MD verfasserin aut Giovanni Guaraldi, MD verfasserin aut Patrizia Comoli, MD verfasserin aut Francesca Facchini, MD verfasserin aut Leonardo Potenza, MD, PhD verfasserin aut William Gennari, MD verfasserin aut Mauro Codeluppi, MD verfasserin aut Mario Luppi, MD, PhD verfasserin aut Gianni Cappelli, MD verfasserin aut Inge C. Gyssens, MD, PhD verfasserin aut Cristina Mussini, MD verfasserin aut In Transplantation Direct Wolters Kluwer, 2017 3(2017), 7, p e182 (DE-627)883765349 (DE-600)2890276-2 23738731 nnns volume:3 year:2017 number:7, p e182 https://doi.org/10.1097/TXD.0000000000000703 kostenfrei https://doaj.org/article/1f6103a933bd4ee2a3410deb9d051090 kostenfrei http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000703 kostenfrei https://doaj.org/toc/2373-8731 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2039 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2068 GBV_ILN_2093 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2119 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_2446 GBV_ILN_2507 GBV_ILN_2869 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4346 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 GBV_ILN_4753 AR 3 2017 7, p e182
allfieldsSound	10.1097/TXD.0000000000000703 doi (DE-627)DOAJ011962062 (DE-599)DOAJ1f6103a933bd4ee2a3410deb9d051090 DE-627 ger DE-627 rakwb eng RD1-811 Erica Franceschini, MD verfasserin aut Clinical Utility of Epstein-Barr Virus Viral Load Monitoring and Risk Factors for Posttransplant Lymphoproliferative Disorders After Kidney Transplantation: A Single-Center, 10-Year Observational Cohort Study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background. Posttransplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality in solid organ transplants. Epstein Barr virus (EBV) plays a major role in PTLD development. Guidelines recommend EBV viral load (VL) monitoring in high-risk populations in the first year. Methods. Retrospective observational study in all adult patients who had at least 1 EBV-VL performed in the postkidney transplant (KT) period from January 2005 to December 2014 at the Policlinico Modena Hospital. We compared patients with negative EBV-DNA to patients with positive EBV-DNA and we described PTLD developed in the study period. Results. One hundred ninety (36.3%) KT patients of 523 were screened for EBV-DNA with 796 samples. One hundred twenty-eight (67.4%) of 190 tested patients presented at least 1 positive sample for EBV. Older age, the use of sirolimus, everolimus, and steroids were associated with EBV-DNA positivity in the univariate analysis. Nine (1.7%) of 523 patients had PTLD. Incidence rate of PTLD in the KT cohort was 0.19/100 person year follow-up (95% confidence interval, 0.09-0.37). One of 9 patients developed early PTLD and was a high-risk patient. Only this PTLD case was positive for EBV. No PTLD case had an EBV-VL superior to 4000 copies/mL. Conclusions. Our results suggest that the keystone of PTLD diagnosis is the clinical suspicion. Our study suggests that, in line with guidelines, EBV-VL assays may be avoided in low-risk patients in the absence of a strong clinical PTLD suspicion without increasing patients' risk of developing PTLD. This represents a safe and cost-saving clinical strategy for our center. Surgery Jessica Plessi, MD verfasserin aut Stefano Zona, MD verfasserin aut Antonella Santoro, MD verfasserin aut Margherita Digaetano, MD verfasserin aut Francesco Fontana, MD verfasserin aut Gaetano Alfano, MD verfasserin aut Giovanni Guaraldi, MD verfasserin aut Patrizia Comoli, MD verfasserin aut Francesca Facchini, MD verfasserin aut Leonardo Potenza, MD, PhD verfasserin aut William Gennari, MD verfasserin aut Mauro Codeluppi, MD verfasserin aut Mario Luppi, MD, PhD verfasserin aut Gianni Cappelli, MD verfasserin aut Inge C. Gyssens, MD, PhD verfasserin aut Cristina Mussini, MD verfasserin aut In Transplantation Direct Wolters Kluwer, 2017 3(2017), 7, p e182 (DE-627)883765349 (DE-600)2890276-2 23738731 nnns volume:3 year:2017 number:7, p e182 https://doi.org/10.1097/TXD.0000000000000703 kostenfrei https://doaj.org/article/1f6103a933bd4ee2a3410deb9d051090 kostenfrei http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000703 kostenfrei https://doaj.org/toc/2373-8731 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2039 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2068 GBV_ILN_2093 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2119 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_2446 GBV_ILN_2507 GBV_ILN_2869 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4346 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 GBV_ILN_4753 AR 3 2017 7, p e182
language	English
source	In Transplantation Direct 3(2017), 7, p e182 volume:3 year:2017 number:7, p e182
sourceStr	In Transplantation Direct 3(2017), 7, p e182 volume:3 year:2017 number:7, p e182
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Surgery
isfreeaccess_bool	true
container_title	Transplantation Direct
authorswithroles_txt_mv	Erica Franceschini, MD @@aut@@ Jessica Plessi, MD @@aut@@ Stefano Zona, MD @@aut@@ Antonella Santoro, MD @@aut@@ Margherita Digaetano, MD @@aut@@ Francesco Fontana, MD @@aut@@ Gaetano Alfano, MD @@aut@@ Giovanni Guaraldi, MD @@aut@@ Patrizia Comoli, MD @@aut@@ Francesca Facchini, MD @@aut@@ Leonardo Potenza, MD, PhD @@aut@@ William Gennari, MD @@aut@@ Mauro Codeluppi, MD @@aut@@ Mario Luppi, MD, PhD @@aut@@ Gianni Cappelli, MD @@aut@@ Inge C. Gyssens, MD, PhD @@aut@@ Cristina Mussini, MD @@aut@@
publishDateDaySort_date	2017-01-01T00:00:00Z
hierarchy_top_id	883765349
id	DOAJ011962062
language_de	englisch
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callnumber-first	R - Medicine
author	Erica Franceschini, MD
spellingShingle	Erica Franceschini, MD misc RD1-811 misc Surgery Clinical Utility of Epstein-Barr Virus Viral Load Monitoring and Risk Factors for Posttransplant Lymphoproliferative Disorders After Kidney Transplantation: A Single-Center, 10-Year Observational Cohort Study
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topic_title	RD1-811 Clinical Utility of Epstein-Barr Virus Viral Load Monitoring and Risk Factors for Posttransplant Lymphoproliferative Disorders After Kidney Transplantation: A Single-Center, 10-Year Observational Cohort Study
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title	Clinical Utility of Epstein-Barr Virus Viral Load Monitoring and Risk Factors for Posttransplant Lymphoproliferative Disorders After Kidney Transplantation: A Single-Center, 10-Year Observational Cohort Study
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title_full	Clinical Utility of Epstein-Barr Virus Viral Load Monitoring and Risk Factors for Posttransplant Lymphoproliferative Disorders After Kidney Transplantation: A Single-Center, 10-Year Observational Cohort Study
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author_browse	Erica Franceschini, MD Jessica Plessi, MD Stefano Zona, MD Antonella Santoro, MD Margherita Digaetano, MD Francesco Fontana, MD Gaetano Alfano, MD Giovanni Guaraldi, MD Patrizia Comoli, MD Francesca Facchini, MD Leonardo Potenza, MD, PhD William Gennari, MD Mauro Codeluppi, MD Mario Luppi, MD, PhD Gianni Cappelli, MD Inge C. Gyssens, MD, PhD Cristina Mussini, MD
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title_sort	clinical utility of epstein-barr virus viral load monitoring and risk factors for posttransplant lymphoproliferative disorders after kidney transplantation: a single-center, 10-year observational cohort study
callnumber	RD1-811
title_auth	Clinical Utility of Epstein-Barr Virus Viral Load Monitoring and Risk Factors for Posttransplant Lymphoproliferative Disorders After Kidney Transplantation: A Single-Center, 10-Year Observational Cohort Study
abstract	Background. Posttransplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality in solid organ transplants. Epstein Barr virus (EBV) plays a major role in PTLD development. Guidelines recommend EBV viral load (VL) monitoring in high-risk populations in the first year. Methods. Retrospective observational study in all adult patients who had at least 1 EBV-VL performed in the postkidney transplant (KT) period from January 2005 to December 2014 at the Policlinico Modena Hospital. We compared patients with negative EBV-DNA to patients with positive EBV-DNA and we described PTLD developed in the study period. Results. One hundred ninety (36.3%) KT patients of 523 were screened for EBV-DNA with 796 samples. One hundred twenty-eight (67.4%) of 190 tested patients presented at least 1 positive sample for EBV. Older age, the use of sirolimus, everolimus, and steroids were associated with EBV-DNA positivity in the univariate analysis. Nine (1.7%) of 523 patients had PTLD. Incidence rate of PTLD in the KT cohort was 0.19/100 person year follow-up (95% confidence interval, 0.09-0.37). One of 9 patients developed early PTLD and was a high-risk patient. Only this PTLD case was positive for EBV. No PTLD case had an EBV-VL superior to 4000 copies/mL. Conclusions. Our results suggest that the keystone of PTLD diagnosis is the clinical suspicion. Our study suggests that, in line with guidelines, EBV-VL assays may be avoided in low-risk patients in the absence of a strong clinical PTLD suspicion without increasing patients' risk of developing PTLD. This represents a safe and cost-saving clinical strategy for our center.
abstractGer	Background. Posttransplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality in solid organ transplants. Epstein Barr virus (EBV) plays a major role in PTLD development. Guidelines recommend EBV viral load (VL) monitoring in high-risk populations in the first year. Methods. Retrospective observational study in all adult patients who had at least 1 EBV-VL performed in the postkidney transplant (KT) period from January 2005 to December 2014 at the Policlinico Modena Hospital. We compared patients with negative EBV-DNA to patients with positive EBV-DNA and we described PTLD developed in the study period. Results. One hundred ninety (36.3%) KT patients of 523 were screened for EBV-DNA with 796 samples. One hundred twenty-eight (67.4%) of 190 tested patients presented at least 1 positive sample for EBV. Older age, the use of sirolimus, everolimus, and steroids were associated with EBV-DNA positivity in the univariate analysis. Nine (1.7%) of 523 patients had PTLD. Incidence rate of PTLD in the KT cohort was 0.19/100 person year follow-up (95% confidence interval, 0.09-0.37). One of 9 patients developed early PTLD and was a high-risk patient. Only this PTLD case was positive for EBV. No PTLD case had an EBV-VL superior to 4000 copies/mL. Conclusions. Our results suggest that the keystone of PTLD diagnosis is the clinical suspicion. Our study suggests that, in line with guidelines, EBV-VL assays may be avoided in low-risk patients in the absence of a strong clinical PTLD suspicion without increasing patients' risk of developing PTLD. This represents a safe and cost-saving clinical strategy for our center.
abstract_unstemmed	Background. Posttransplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality in solid organ transplants. Epstein Barr virus (EBV) plays a major role in PTLD development. Guidelines recommend EBV viral load (VL) monitoring in high-risk populations in the first year. Methods. Retrospective observational study in all adult patients who had at least 1 EBV-VL performed in the postkidney transplant (KT) period from January 2005 to December 2014 at the Policlinico Modena Hospital. We compared patients with negative EBV-DNA to patients with positive EBV-DNA and we described PTLD developed in the study period. Results. One hundred ninety (36.3%) KT patients of 523 were screened for EBV-DNA with 796 samples. One hundred twenty-eight (67.4%) of 190 tested patients presented at least 1 positive sample for EBV. Older age, the use of sirolimus, everolimus, and steroids were associated with EBV-DNA positivity in the univariate analysis. Nine (1.7%) of 523 patients had PTLD. Incidence rate of PTLD in the KT cohort was 0.19/100 person year follow-up (95% confidence interval, 0.09-0.37). One of 9 patients developed early PTLD and was a high-risk patient. Only this PTLD case was positive for EBV. No PTLD case had an EBV-VL superior to 4000 copies/mL. Conclusions. Our results suggest that the keystone of PTLD diagnosis is the clinical suspicion. Our study suggests that, in line with guidelines, EBV-VL assays may be avoided in low-risk patients in the absence of a strong clinical PTLD suspicion without increasing patients' risk of developing PTLD. This represents a safe and cost-saving clinical strategy for our center.
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title_short	Clinical Utility of Epstein-Barr Virus Viral Load Monitoring and Risk Factors for Posttransplant Lymphoproliferative Disorders After Kidney Transplantation: A Single-Center, 10-Year Observational Cohort Study
url	https://doi.org/10.1097/TXD.0000000000000703 https://doaj.org/article/1f6103a933bd4ee2a3410deb9d051090 http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000703 https://doaj.org/toc/2373-8731
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up_date	2024-07-03T23:05:51.106Z
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fullrecord_marcxml	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">DOAJ011962062</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230310041359.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">230225s2017 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1097/TXD.0000000000000703</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)DOAJ011962062</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)DOAJ1f6103a933bd4ee2a3410deb9d051090</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RD1-811</subfield></datafield><datafield tag="100" ind1="0" ind2=" "><subfield code="a">Erica Franceschini, MD</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Clinical Utility of Epstein-Barr Virus Viral Load Monitoring and Risk Factors for Posttransplant Lymphoproliferative Disorders After Kidney Transplantation: A Single-Center, 10-Year Observational Cohort Study</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2017</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background. Posttransplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality in solid organ transplants. Epstein Barr virus (EBV) plays a major role in PTLD development. Guidelines recommend EBV viral load (VL) monitoring in high-risk populations in the first year. Methods. Retrospective observational study in all adult patients who had at least 1 EBV-VL performed in the postkidney transplant (KT) period from January 2005 to December 2014 at the Policlinico Modena Hospital. We compared patients with negative EBV-DNA to patients with positive EBV-DNA and we described PTLD developed in the study period. Results. One hundred ninety (36.3%) KT patients of 523 were screened for EBV-DNA with 796 samples. One hundred twenty-eight (67.4%) of 190 tested patients presented at least 1 positive sample for EBV. Older age, the use of sirolimus, everolimus, and steroids were associated with EBV-DNA positivity in the univariate analysis. Nine (1.7%) of 523 patients had PTLD. Incidence rate of PTLD in the KT cohort was 0.19/100 person year follow-up (95% confidence interval, 0.09-0.37). One of 9 patients developed early PTLD and was a high-risk patient. Only this PTLD case was positive for EBV. No PTLD case had an EBV-VL superior to 4000 copies/mL. Conclusions. Our results suggest that the keystone of PTLD diagnosis is the clinical suspicion. Our study suggests that, in line with guidelines, EBV-VL assays may be avoided in low-risk patients in the absence of a strong clinical PTLD suspicion without increasing patients' risk of developing PTLD. 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Clinical Utility of Epstein-Barr Virus Viral Load Monitoring and Risk Factors for Posttransplant Lymphoproliferative Disorders After Kidney Transplantation: A Single-Center, 10-Year Observational Cohort Study

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