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                <term xml:lang="en">Retrospective Studies</term>
                <term xml:lang="en">Proportional Hazards Models</term>
                <term xml:lang="en">Postoperative Complications</term>
                <term xml:lang="en">PLTD</term>
                <term xml:lang="en">pediatric renal transplantation</term>
                <term xml:lang="en">Outcome Assessment (Health Care)</term>
                <term xml:lang="en">Male</term>
                <term xml:lang="en">Kidney Transplantation</term>
                <term xml:lang="en">Kaplan-Meier Estimate</term>
                <term xml:lang="en">Newborn</term>
                <term xml:lang="en">Infant</term>
                <term xml:lang="en">Humans</term>
                <term xml:lang="en">Follow-Up Studies</term>
                <term xml:lang="en">Female</term>
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                <term xml:lang="en">EBV</term>
                <term xml:lang="en">Preschool</term>
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              <p>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, &gt;=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.</p>
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