Predictors of Post Transplant Lymphoprolipherative Disorder Among Adult Kidney Transplant Recipients.
Internal Medicine, University of Wisconsin School of Medicine, Madison, WI.
Meeting: 2016 American Transplant Congress
Abstract number: C298
Keywords: Kidney transplantation, Post-transplant lymphoproliferative disorder (PTLD), Risk factors
Session Information
Session Name: Poster Session C: Viruses and SOT
Session Type: Poster Session
Date: Monday, June 13, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Objective: Identifying predictors of Post Transplant Lymphoprolipherative Disorder (PTLD); early (0 – 3 years) and late in kidney transplantation.
Methodology: Single center longitudinal study among kidney transplant only recipients during 1994 – 2013. Out of 4410 kidneys transplant recipients 66 developed PTLD. Recipients with pre-transplant Cancer excluded.
| No PTLD (N=4344) | PTLD (N=66) | P | |
| Age | 48.2 (14.5) | 47.8 (13.9) | 0.82 |
| Female | 40.1 | 37.9 | 0.71 |
| Non-white | 16.0 | 7.6 | 0.06 |
| BMI | 27.0 | 26.3 | 0.28 |
| DCD | 12.0 | 10.6 | 0.73 |
| Prior Transplant | 15.1 | 25.8 | 0.02 |
| EBV Pretransplant + | 94.0 | 68.2 | <0.001 |
| CMV Pretransplant + | 54.2 | 43.9 | 0.10 |
| > 3 HLA mismatch | 47.2 | 34.8 | 0.05 |
| GN | 16.6 | 22.7 | 0.32 |
| DM 1 | 9.8 | 12.1 | 0.32 |
| DM 2 | 14.7 | 10.6 | 0.32 |
| CNI | 1.1 | 0 | 0.32 |
| HTN | 10.3 | 3.0 | 0.32 |
| FSGS | 6.4 | 7.6 | 0.32 |
| SLE | 3.5 | 6.1 | 0.32 |
| Other diseases | 44.1 | 45.5 | 0.32 |
| Thymoglobulin | 23.1 | 18.2 | <0.001 |
| Campath | 17.2 | 9.1 | <0.001 |
| Simulect | 49.7 | 33.3 |
<0.001 |
| OKT3 | 7.8 | 19.7 | <0.001 |
| Other induction | 15.8 | 33.3 | <0.001 |
| Tacrolimus Maintenance | 48.3 | 37.9 | 0.09 |
|
Early PTLD (0 – 3 Years) (N=25) |
Late PTLD (> 3 years) (N=41) |
P | |
| Age | 48.6 (17.0) | 47.2 (11.8) | 0.70 |
| Female | 32.0 | 41.4 | 0.44 |
| Non-white | 8.0 | 7.3 | 0.92 |
| BMI | 27.2 (7.5) | 25.8 (5.0) | 0.36 |
| DCD | 20.0 | 4.9 | 0.05 |
| Prior Transplant | 16.0 | 31.7 | 0.16 |
| EBV Pretransplant + | 44.0 | 82.9 | 0.001 |
| CMV Pretransplant + | 40.0 | 46.3 | 0.62 |
| GN | 12.0 | 29.3 | 0.08 |
| DM 1 | 4.0 | 17.1 | 0.08 |
| DM 2 | 20.0 | 4.9 | 0.08 |
| HTN | 4.0 | 2.4 | 0.08 |
| Other diseases | 60.0 | 46.3 | 0.08 |
| Thymoglobulin | 24.0 | 14.6 | 0.05 |
| Campath | 20.0 | 2.4 | 0.05 |
| Simulect | 32.0 | 34.1 | 0.05 |
| OKT3 | 12.0 | 24.4 | 0.05 |
| Tacrolimus Maintenance | 52.0 | 29.3 | 0.07 |
Results: Of 4410 kidneys transplant recipients 66 (1.5%) developed PTLD; 25 (38%) early and 41 (62%) late. In multivariate analyses, induction with OKT3 and pre-transplant (-) EBV serostatus were independent predictors of post-transplant PTLD (Table 1). DM type 2, DCD transplants and tacrolimus maintenance were associated with early PTLD, while pre-transplant (-) EBV, GN, DM type 1, and OKT3 were associated with late PTLD (Table 2).
Conclusion: Pre-transplant negative EBV, SLE, multiple transplantation and OKT3 induction predict PTLD. Patients with these characteristics may benefit from post-transplant EBV close surveillance and immunosuppression regimen minimization.
CITATION INFORMATION: Mohamed M, Parajuli S, Muth B, Djamali A, Astor B. Predictors of Post Transplant Lymphoprolipherative Disorder Among Adult Kidney Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Mohamed M, Parajuli S, Muth B, Djamali A, Astor B. Predictors of Post Transplant Lymphoprolipherative Disorder Among Adult Kidney Transplant Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/predictors-of-post-transplant-lymphoprolipherative-disorder-among-adult-kidney-transplant-recipients/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress