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Pediatric renal transplantation: A retrospective single-center study on epidemiology and morbidity due to EBV

Abstract : Pediatric R-Tx patients are at high risk of developing EBV primary infection. Although high DNA replication is a risk factor for PTLD, some patients develop PTLD with low viral load. In this retrospective single-center study including all pediatric patients having received R-Tx (2003-2012 period), we aimed to identify risk factors for uncontrolled reactions to EBV (defined as the presence of a viral load \textgreater10~000~copies/mL or PTLD). A Cox proportional hazard model was performed. A total of 117 patients underwent R-Tx at a mean age of 9.7~\textpm~5.3~years, 46 of them being seronegative for EBV at the time of R-Tx. During follow-up, 54 patients displayed positive EBV viral load, 22 of whom presenting with primary infection. An uncontrolled reaction to EBV was observed in 24 patients, whilst 4 patients developed PTLD. Univariate and multivariate analyses suggested the following risk factors for an uncontrolled reaction: age below 5~years, graft from a deceased donor, >=5 HLA mismatches, EBV-seronegative status at the time of R-Tx, and a secondary post-Tx loss of anti-EBNA. Monitoring anti-EBNA after R-Tx may contribute to the early identification of patients at risk for uncontrolled reaction.
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https://hal.archives-ouvertes.fr/hal-01917823
Contributor : Christelle Cheval Connect in order to contact the contributor
Submitted on : Friday, November 9, 2018 - 5:07:06 PM
Last modification on : Wednesday, September 15, 2021 - 2:56:02 PM

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A. Laurent, A. Klich, Pascal Roy, Bruno Lina, B. Kassai, et al.. Pediatric renal transplantation: A retrospective single-center study on epidemiology and morbidity due to EBV. Pediatric Transplantation, 2018, 22 (3), pp.e13151. ⟨10.1111/petr.13151⟩. ⟨hal-01917823⟩

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