Posttransplant lymphoproliferative disorder following pancreas transplantation

N. Issa, H. Amer, P. G. Dean, W. K. Kremers, Y. C. Kudva, N. Rostambeigi, F. G. Cosio, T. S. Larson, T. M. Habermann, M. D. Stegall, M. D. Griffin

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


The incidence, risk factors and impact on patient and graft survival were evaluated for posttransplant lymphoproliferative disorder (PTLD) among 212 pancreas transplant recipients. Thirteen (6.1%) developed PTLD during 71 ± 27 months follow-up. Cumulative incidences of PTLD at 1, 3, 5 and 10 years posttransplant were 4.2%, 5.3%, 6.0% and 7.0%, respectively. Incidence of PTLD was lower for recipients of simultaneous pancreas kidney compared to pancreas after kidney transplant or pancreas transplant alone, though not significantly so. Recipient Epstein-Barr virus (EBV) seronegativity and number of doses of depleting antibody therapy administered at transplant were associated with increased risk of PTLD, while recipient age, gender, transplant type, cytomegalovirus mismatch maintenance immunosuppression type and treated acute rejection were not. All 13 cases underwent immunosuppression reduction, and 10 received anti-CD20 monoclonal antibody. During follow-up, 10/13 (77%) responded to treatment with complete remission, while 3 (23%) died as a result of PTLD. Patient and graft survivals did not differ for recipients with and without PTLD. The strong association of PTLD with EBV-seronegativity requires considering this risk factor when evaluating and monitoring pancreas transplant recipients. With reduction of immunosuppression and anti-CD20 therapy, survival for pancreas transplant recipients with PTLD was substantially better than previously reported.

Original languageEnglish (US)
Pages (from-to)1894-1902
Number of pages9
JournalAmerican Journal of Transplantation
Issue number8
StatePublished - Aug 2009


  • Lymphoproliferative disease
  • Pancreas transplantation
  • Prognosis
  • Survival

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


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