Evidence map›Paper›PMID 28706985›Full record

ArticleTransplantation direct2017

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.

Erica Franceschini, Jessica Plessi, Stefano Zona, Antonella Santoro, Margherita Digaetano, Francesco Fontana, Gaetano Alfano, Giovanni Guaraldi, Patrizia Comoli, Francesca Facchini and 7 more

Open access · goldAbstract read
In one paragraph

Article in Transplantation direct, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.5field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 5 institutions in 4 countries.

Erica FranceschiniClinic of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy.
Jessica PlessiClinic of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy.
Stefano ZonaClinic of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy.
Antonella SantoroClinic of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy.
Margherita DigaetanoClinic of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy.
Francesco FontanaClinic of Nephrology, University of Modena and Reggio Emilia, Modena, Italy.
Gaetano AlfanoClinic of Nephrology, University of Modena and Reggio Emilia, Modena, Italy.
Giovanni GuaraldiClinic of Infectious Diseases, University of Modena and Reggio Emilia, Modena, Italy.
Patrizia ComoliPediatric Hematology-Oncology, Fondazione IRCCS Policlinico S Matteo, Pavia, Italy.
Francesca FacchiniClinic of Nephrology, University of Modena and Reggio Emilia, Modena, Italy.
Leonardo PotenzaSection of Hematology, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico Modena, Italy.
William GennariMicrobiology Laboratory, Azienda Ospedaliero-Universitaria Policlinico Modena, Italy.
Mauro CodeluppiClinic of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy.
Mario LuppiSection of Hematology, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico Modena, Italy.
Gianni CappelliClinic of Nephrology, University of Modena and Reggio Emilia, Modena, Italy.
Inge C Gyssens
Cristina MussiniClinic of Infectious Diseases, University of Modena and Reggio Emilia, Modena, Italy.
Policlinico di Modena · ITMay Institute · USUniversity of Modena and Reggio Emilia · ITIstituti di Ricovero e Cura a Carattere Scientifico · ITRadboud University Nijmegen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPosttransplant 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.

methodsRetrospective 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.

resultsOne 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.

conclusionsOur 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.

Identifiers

PMID28706985
PMCPMC5498023
OpenAlexW2725917096

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.