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Background. Posttransplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality in solid\udorgan transplants. Epstein Barr virus (EBV) plays a major role in PTLD development. Guidelines recommend EBV viral load\ud(VL) monitoring in high-risk populations in the first year. Methods. Retrospective observational study in all adult patients\udwho had at least 1 EBV-VL performed in the postkidney transplant (KT) period from January 2005 to December 2014 at\udthe Policlinico Modena Hospital. We compared patients with negative EBV-DNA to patients with positive EBV-DNA and\udwe described PTLD developed in the study period. Results.One hundred ninety (36.3%) KT patients of 523 were screened\udfor EBV-DNA with 796 samples. One hundred twenty-eight (67.4%) of 190 tested patients presented at least 1 positive\udsample for EBV. Older age, the use of sirolimus, everolimus, and steroids were associated with EBV-DNA positivity in the\udunivariate analysis. Nine (1.7%) of 523 patients had PTLD. Incidence rate of PTLD in the KT cohort was 0.19/100 person\udyear follow-up (95% confidence interval, 0.09-0.37). One of 9 patients developed early PTLD and was a high-risk patient.\udOnly this PTLD case was positive for EBV. No PTLD case had an EBV-VL superior to 4000 copies/mL. Conclusions.\udOur results suggest that the keystone of PTLD diagnosis is the clinical suspicion. Our study suggests that, in line with guidelines,\udEBV-VL assays may be avoided in low-risk patients in the absence of a strong clinical PTLD suspicion without\udincreasing patients' risk of developing PTLD. This represents a safe and cost-saving clinical strategy for our cente

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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