The Impact of Epstein–Barr Virus Serostatus Mismatch in Adult Kidney Transplant Recipients: An Analysis of the 2012–2022 OPTN Database
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Wiley
2025
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| author | Namrata Parikh Rose Mary Attieh Hani M. Wadei Michael A. Mao Shennen A. Mao Cemal Burcin Taner Tambi Jarmi Wisit Cheungpasitporn Napat Leeaphorn |
| author_facet | Namrata Parikh Rose Mary Attieh Hani M. Wadei Michael A. Mao Shennen A. Mao Cemal Burcin Taner Tambi Jarmi Wisit Cheungpasitporn Napat Leeaphorn Namrata Parikh Rose Mary Attieh Hani M. Wadei Michael A. Mao Shennen A. Mao Cemal Burcin Taner Tambi Jarmi Wisit Cheungpasitporn Napat Leeaphorn |
| collection | Wiley Open Access |
| contents | The Impact of Epstein–Barr Virus Serostatus Mismatch in Adult Kidney Transplant Recipients: An Analysis of the 2012–2022 OPTN Database Namrata Parikh Rose Mary Attieh Hani M. Wadei Michael A. Mao Shennen A. Mao Cemal Burcin Taner Tambi Jarmi Wisit Cheungpasitporn Napat Leeaphorn Clinical Transplantation ABSTRACTBackground and AimsOne strategy to minimize the risk of posttransplant lymphoproliferative disorder (PTLD) is to avoid an Epstein–Barr Virus (EBV) mismatch through kidney paired donation. We aimed to estimate the incidence of PTLD in EBV‐negative kidney transplant recipients with EBV‐positive donors (D+/R−) and evaluate the excess risk of death following the occurrence of PTLD.MethodsWe included adult patients in OPTN database who underwent kidney transplants between 2012 and 2022. Cox regression analysis was employed to evaluate the impact of EBV serostatus on the development of PTLD, and to assess mortality following PTLD diagnosis in D+/R− individuals.ResultsA total of 179 068 patients were included, with 92.8% in the R+, 6.4% in the D+/R−, and 0.8% in the D−/R− group. D+/R− exhibited a significantly higher risk of PTLD compared to R+ and D−/R− groups. D+/R− had a greater risk of PTLD when compared to D−/R− recipients (aHR: 3.82; p < 0.001). Among D+/R− recipients, those who developed PTLD had a significantly higher risk of mortality (aHR: 2.28; p < 0.001 in deceased donor kidney transplant [DDKT] and aHR: 5.22; p < 0.001 in living donor kidney transplant [LDKT]).ConclusionsD+/R− recipients have nearly a fourfold higher risk of PTLD compared to D−/R− recipients, suggesting that choosing an EBV D−/R− transplant could reduce the PTLD risk by about 73%. This data is crucial for counseling EBV‐negative patients considering kidney paired donation to avoid an EBV serostatus mismatch. 10.1111/ctr.70117 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/ctr.70117 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_ctr_70117 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | The Impact of Epstein–Barr Virus Serostatus Mismatch in Adult Kidney Transplant Recipients: An Analysis of the 2012–2022 OPTN Database Namrata Parikh Rose Mary Attieh Hani M. Wadei Michael A. Mao Shennen A. Mao Cemal Burcin Taner Tambi Jarmi Wisit Cheungpasitporn Napat Leeaphorn Clinical Transplantation The Impact of Epstein–Barr Virus Serostatus Mismatch in Adult Kidney Transplant Recipients: An Analysis of the 2012–2022 OPTN Database Namrata Parikh Rose Mary Attieh Hani M. Wadei Michael A. Mao Shennen A. Mao Cemal Burcin Taner Tambi Jarmi Wisit Cheungpasitporn Napat Leeaphorn Clinical Transplantation ABSTRACTBackground and AimsOne strategy to minimize the risk of posttransplant lymphoproliferative disorder (PTLD) is to avoid an Epstein–Barr Virus (EBV) mismatch through kidney paired donation. We aimed to estimate the incidence of PTLD in EBV‐negative kidney transplant recipients with EBV‐positive donors (D+/R−) and evaluate the excess risk of death following the occurrence of PTLD.MethodsWe included adult patients in OPTN database who underwent kidney transplants between 2012 and 2022. Cox regression analysis was employed to evaluate the impact of EBV serostatus on the development of PTLD, and to assess mortality following PTLD diagnosis in D+/R− individuals.ResultsA total of 179 068 patients were included, with 92.8% in the R+, 6.4% in the D+/R−, and 0.8% in the D−/R− group. D+/R− exhibited a significantly higher risk of PTLD compared to R+ and D−/R− groups. D+/R− had a greater risk of PTLD when compared to D−/R− recipients (aHR: 3.82; p < 0.001). Among D+/R− recipients, those who developed PTLD had a significantly higher risk of mortality (aHR: 2.28; p < 0.001 in deceased donor kidney transplant [DDKT] and aHR: 5.22; p < 0.001 in living donor kidney transplant [LDKT]).ConclusionsD+/R− recipients have nearly a fourfold higher risk of PTLD compared to D−/R− recipients, suggesting that choosing an EBV D−/R− transplant could reduce the PTLD risk by about 73%. This data is crucial for counseling EBV‐negative patients considering kidney paired donation to avoid an EBV serostatus mismatch. 10.1111/ctr.70117 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | The Impact of Epstein–Barr Virus Serostatus Mismatch in Adult Kidney Transplant Recipients: An Analysis of the 2012–2022 OPTN Database |
| topic | Clinical Transplantation |
| url | https://onlinelibrary.wiley.com/doi/10.1111/ctr.70117 |