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Impact of Donor and Recipient Pretransplant EBV Antibody Status on PTLD Incidence in Adult Kidney Transplant Recipients

N. Chandolias, K. Gillingham, H. Balfour, Jr, A. Matas

Surgery and Lab Medicine and Pathology, U Mn, Mpls, MN

Meeting: 2013 American Transplant Congress

Abstract number: D1716

We studied the impact of pretransplant (pretx) EBV antibody (ab) status on the incidence of PTLD in adult primary kidney tx recipients. Between 1/2002 and 12/2011, 1446 adults with known pretx EBV ab status underwent primary tx (609 DD; 837 LD). All recipients were followed through 9/2012.

Adult EBV-naive (ab negative pretx) recipients were significantly more like to develop PTLD (p<0.0001) (Table 1). New onset PTLD occurred throughout the years of follow-up in the EBV-naive recipients (Table 1). For EBV ab+ recipients, mean age (±SD) at transplant was 51± 13 yrs; for EBV-naive recipients, 45±15 yrs (p.=0.0005). For EBV ab+ recipients, mean age (±SD) at PTLD diagnosis was 57±12; for EBV naive recipients, 56±17 (NS). The risk of PTLD was similar for EBV- naive recipients who received a living or deceased donor kidney (Table 1).

Table 1: Actuarial PTLD-free Survival by EBV Status (Primary Tx)
Yrs Post Tx % PTLD Survival
  EBV- (n=87) EBV+ (n=1277)   DD, EBV- (n=32) DD, EBV+ (n=521) LD, EBV- (n=55) LD, EBV+ (n=756)
1 99.7% 99.8%   96.4% 99.3% 100% 100%
2 99.7% 99.7%   96.4% 99.3% 100% 99.9%
3 96.7% 99.7%   96.4% 99.1% 96.4% 99.9%
4 94.5% 99.4%   91.6% 99.1% 96.4% 99.6%
5 94.5% 99.4%   91.6% 99.1% 96.4% 99.6%
6 90.7% 99.4%   91.6% 99.1% 90.4% 99.6%
7 90.7% 99.4%   91.6% 99.1% 90.4% 99.6%
8 90.7% 99%   91.6% 99.1% 90.4% 99.1%
9 79% 99%   91.6% 99.1% 90.4% 99.1%

1083 recipients had complete information on donor (D) and recipient (R) EBV status. PTLD-free survival by D/R status is shown in Table 2 (D+/R+; D+R-; D-R+; D-R-). D+/R- transplants were associated with significantly ⇓ PTLD-free survival vs D+/R+ (p=0.008) and D-R- (p=0.01).

Table 2: Actuarial PTLD-free Survival by Donor and Recipient EBV Serology
Yrs Post Tx % PTLD-free Survival
  D+ R+ (n=944) D+ R- (n=66) D- R+ (n=67) D- R- (n=6)
1 99.9% 100% 98.4% 100%
2 99.8% 100% 98.4%
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To cite this abstract in AMA style:

Chandolias N, Gillingham K, Balfour H, Matas A. Impact of Donor and Recipient Pretransplant EBV Antibody Status on PTLD Incidence in Adult Kidney Transplant Recipients [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/impact-of-donor-and-recipient-pretransplant-ebv-antibody-status-on-ptld-incidence-in-adult-kidney-transplant-recipients/. Accessed May 17, 2025.

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