Posttransplant lymphoproliferative diseases (PTLD)

What are posttransplant lymphoproliferative diseases (PTLD) and the risk factors?

PTLD is a well-recognized complication of the immunosuppression in the kidney transplant patient. Epstein-Barr virus (EBV) is found in two-thirds of PTLD cases. PTLD in kidney transplant patients is mainly a B cell–derived, large cell lymphoma.

Risk factors for PTLD include:

  • • Degree of immunosuppression such as the use of lymphocyte-depleting agents
  • • Transplantation between EBV-positive donor and EBV-negative recipient
  • • <25-year-old recipient
  • • Pretransplant malignancy
  • • PTLD occurs in 0.6% to 1.5% of patients after kidney transplantation, with the majority in the first year
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