The Changing Epidemiology of Posttransplant Lymphoproliferative Disorder in Adult Solid Organ Transplant Recipients Over 30 Years: A Single Center Experience

AbstractBackgroundPosttransplant lymphoproliferative disorders (PTLD) are a complication of solid organ transplantation (SOT) associated with Epstein-Barr virus (EBV).MethodsWe analyzed the incidence of and risk factors for PTLD among adult SOT recipients at our center over 30 years (1984–2013). We also compared PTLD incidence before and after a prevention strategy of EBV viral load monitoring in EBV serology mismatched patients was adopted in 2001 (ie transplant era 1 (1983–2001) vs era 2 (2002–13)).ResultsAmong 4171 SOT patients, 109 developed PTLD. Cumulative incidence at 1, 10 and 20 years posttransplant was 0.95, 2.3 and 3.5 per 100 person-years, respectively. Beyond the first year peak of almost exclusively EBV positive PTLD, a lower incidence of PTLD, predominantly EBV negative, persisted for 20 years. Thoracic transplant (hazard ratio (HR) 2.1, p=0.007) and negative EBV serology (HR 7.7, p

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