What is the relationship between ebv and PTLD?
EBV is present in 95% of the adult US population. Kidney recipients that are EBV negative receiving an organ from an EBV-positive donor are at increased risk of PTLD. After infection, the virus persists in B-cell lymphocytes and can lead to cell transformation. This transformation leads to a persistently activated B cell that is constantly replicating. Normally in the immunocompetent patient, the body’s cellular component of the immune system (helper and cytotoxic T cells, natural killer cells) eliminate these “transformed” B cells. However, with immunosuppression, this regulatory process does not respond appropriately, and PTLD can develop. This is why PTLD is more common in the first year post transplant after induction therapy and higher levels of maintenance immunosuppression.