In a longuitudinal study,we evaluated the cumulative incidence of Posttransplant limphoproliferative disorders(PTLD),its relationship with Epstein Barr Virus (EBV),classical risk factors and outcome in 21546 single renal adult recipients transplanted in 21 hospital from 1990 to 2009.Records were censored at death or end of the study,december 31st 2014 to allow at least 5 years posttransplant follow up.A total of 272 recipients(70,9%males,aged 50,6(4,7)years,88% first transplants,97,7% from deceased donors)developed PTLD( 1,2%)8.18 cases(8.16,8.19)/10.000 patients/year.PTLD occurred 42 months posttransplant (IQR 12-77,5),81.7 in recipients tested EBV+ in tissue(IQR 25-129)and 82.8 in EBV-(IQR 41-109) (P:0.725).Cumulative incidence was 1,7[permil],5,7[permil] and 10,5[permil] at 1, 5 and 10 years posttransplant.The highest incidence per year was 1,4[permil] the first year,being under 1[permil] the following years. At diagnosis the recipients received cyclosporine(58,8%), FK(35,4%),micophenolate(40,3%), azathioprine(22,6%)and steroids(83.1%) .EBV in tissue was reported in 94 out of the 155 tested recipients(60.6%)and 86.0% were B cell lymphomas .One hundred eighty-eight recipients(69.1%)showed classical risk factors being antilymphocyte antibodies treatment the most frequent.During follow-up,172 patients died(63,2%)and 100 (36,7%)had complete remission, 20 of them losing their grafts(20%).The main cause of death was PTLD progression(n=91, 52,9%),followed by sepsis(n=24,13,9%).Median follow-up of recipients with PTLD was 12 months after diagnosis(1-226months).Patient survival after PTLD was 53%,46% and 40% at 1, 2 and 5 years.and graft survival was 48%, 39% and 33%.In conclusion,PTLD in kidney transplant recipients are mainly B cell proliferations in close relationship with EBV.There is no relation between EVB in tissue and appearence after transplant.They usually develop in the presence of classical risk factors,mainly the use of antilymphocyte antibodies.Although PTLD incidence is low,prognosis at 1 year is poor ,primarily due to PTLD progression, but survivors can even mantain their grafts.

CITATION INFORMATION: Franco A, Hernandez D, Maruri N, Alonso A, Crespo M, Mazuecos A, Diaz-Corte C, Gentil M. Lymphoproliferative Disorders After Renal Transplantation Along Two Decades: A Large Longitudinal Study. Am J Transplant. 2017;17 (suppl 3).

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