20 September 2025
: Case report 
Pediatric Liver Transplant Complications: EBV-Associated Tumors and Infection Management Strategies
Rare coexistence of disease or pathology
Li-Na Wu ABCDEF 1,2,3,4, Zhi-Gui Zeng BDE 2,3,4,5, Jing-Yi Liu
CDE 1,6,3,4, Lin Wei BD 6,3,4,5, Yu-Le Tan B 6,3,4,5, Fu-Xiao Xie CD 6,3,4,5, Zhi-Jun Zhu AF 6,3,4,5*, Li-Ying Sun A 1,6,3,7
DOI: 10.12659/AJCR.948566
Am J Case Rep 2025; 26:e948566
Table 2 Literature review of EBV-SMT.
| Reference | l/Yrs | Sex | Organ | IS | Time*/Yr | EBV-IgG D/R | EBV DNA (copies/ml) | SMT location | Co-exist PTLD | Treatment for EBV-SMT | Outcome | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SC | RIS | mTORi | RTX | CT/RT | Others | |||||||||||
| []10 | 8mo | F | Heart | TAC | 5 | NM | 286 000 | Sigmoid colon, rectum | NM | Y | CR | |||||
| 6 | F | Heart | TAC | 4 | NM | 11 848 | Liver, left kidney | Y | Y | Y | Both | T cell therapy | CR | |||
| []17 | 10 | M | Kidney | TAC/SRL | 2 | R− | 600 972 | Ureter | NM | Y | Y | PR | ||||
| []16 | 3 | F | Liver | TAC/RAPA | 3 | NM | 625 000 | Brain, spleen, liver, kidneys, and lungs | N | Y | Y | PD | ||||
| 5 | F | Blood | CSA | 2 | NM | NM | Brain | Y | Y | NM | ||||||
| []2 | 4mo | F | Heart | TAC | 1.7 | D+/R− | 97 500 | Liver, lung, GI | Y | Y | Y | CT | Death | |||
| 8mo | F | Heart | TAC | 1.3 | D+/R− | 1 055 000 | Adrenal glands | Y | Y | Y | CR | |||||
| 2 | F | Heart | TAC/CSA | 4.2 | D+/R− | 100 000 | Liver, spleen, lungs, brain | Y | Y | CT | Death | |||||
| []14 | 5 | F | Blood | TAC | 4 | NM | NM | Liver | N | Y | Y | PR | ||||
| []18 | 16/EBV-SMT | F | Heart | NM | NM | NM | NM | Liver, GI | Y | Y | Y | T cell therapy | Death | |||
| []19 | 0.5mo | F | Heart | TAC | 8 | NM | 131 600 | Liver, Mesentery, muscles | N | Y | Y | Y | CR | |||
| []20 | 8.5mo | M | Multi-organ | NM | 3.4 | NM | NM | Liver | N | NM | Death | |||||
| 7 | F | NM | 3.5 | NM | NM | Adrenal glands | Y | NM | CR | |||||||
| []7 | 3.5mo | F | Kidney | TAC | 3 | R− | NM | Peritoneum | N | CT | PR | |||||
| []15 | 3.75 | M | Kidney | TAC | 1.7 | D−/R+ | 137 734 | Spleen | Y | Y | Y | T cell therapy | PR | |||
| 11mo | M | Heart | TAC | 3 | D−/R+ | 0 | Liver, spleen, lungs | Y | Y | Y | T cell therapy | Death for pneu-monia | ||||
| []21 | 10mo | F | liver | TAC | 2 | D+/R− | 1300 | Liver, Ileum | N | Y | Y | Y | RT | CR | ||
| []22 | 13 | F | Kidney | TAC | 3 | NM | NM | Colon, pulmonary, liver | NM | Y | PR | |||||
| 2.5 | M | Kidney | TAC | 2.5 | NM | NM | Liver, spleen | NM | Y | PD | ||||||
| Our case | 5mo | M | Liver | TAC | 2.7 | D+/R− | 3 393 444 | Liver, spleen | Y | Y | Y | Y | Y | CR | ||
| * Time was defined as interval time between LT and EBV-SMT. IS – immunosuppressants; Interval time –the interval time between diagnose and transplantation; GI – gastrointestinal tract; CT – chemotherapy; RT – radiotherapy; RIS – reduced immunosuppressants; NM – not mention; TAC – tacrolimus; CSA, – cyclosporine; SRL – sirolimus; RTX – Rituximab; CR – complete response; PR – partial response; PD – progressive. | ||||||||||||||||