Temporal Increase in the Incidence of Post-Transplantation Lymphoproliferative Disorder in Adult Renal Transplant Recipients: Analysis of 2 US Insurance Administrative Claims Databases

T. Kou, H.-U. Meier-Kriesche, J. Preston, A. Gomez.

Bristol-Myers Squibb Company, Princeton, NJ.

Meeting: 2015 American Transplant Congress

Abstract number: D44

Keywords: Kidney transplantation, Post-transplant lymphoproliferative disorder (PTLD), Safety

Session Information

Session Name: Poster Session D: Diabetes/Metabolic/Bone/Malignancy/Pregnancy

Session Type: Poster Session

Date: Tuesday, May 5, 2015

Session Time: 5:30pm-6:30pm

Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

Purpose: Post-transplant lymphoproliferative disorder (PTLD) is a serious complication after kidney transplant. In a prior analysis using Medicare claims database from 1995 to 2003, the 1-year incidence rate for PTLD was 0.46 per 100 person-years with 95% CI: 0.39-0.53 (Kasiske, et al, 2011). Using 2 US insurance claims databases, this study examined the changes in the risk of PTLD in patients with kidney transplant over recent years. Methods: A total of 7,796 kidney transplant recipients in Truven Health MarketScan (cohort 1) and 5,466 in PharMetrics (cohort 2) were included in this analysis. The ascertainment of PTLD case was based on ICD-9-CM codes for PTLD and B-cell lymphoma in the claims records. The incidence rates of PTLD by 1 year post-transplantation and 95% CIs were estimated by calendar year in each cohort. Results: In the claims database cohorts between Jan 2008 and July 2011, the incidence rates of PTLD by 1 year post-transplant demonstrated a trend towards increase from 0.33-0.46 per 100 person-years in 2008-2009 to 0.73-0.78 per 100 person-years in 2010-2011.


	Cohort 1			Cohort 2
Calendar Year	N	Incidence rate by 1 y (95% CI)	Rate Ratio (95% CI)	N	Incidence rate by 1 y (95% CI)	Rate Ratio (95% CI)
2008 – 2009	4519	0.33 (0.20-0.55)	Reference	3285	0.46 (0.28-0.62)	Reference
2010 – July 2011	3274	0.73 (0.49-1.09)	2.22 (1.16-4.20)	2181	0.78 (0.49-1.24)	1.71 (0.85-3.41)

The rate ratios demonstrated a significant increase in cohort 1 and a trend towards increase in cohort 2. Conclusion: In kidney transplant recipients, the incidence of PTLD in 2 large insurance claims databases showed a trend towards increase in more recent years. The findings could imply that recent, more potent immunosuppressive regimens may be associated with higher risk of PTLD in the first year post-kidney transplant. Overall, the incidence is in line or slightly higher with that reported by Kasiske el al from Medicare claims files.

To cite this abstract in AMA style:

Kou T, Meier-Kriesche H-U, Preston J, Gomez A. Temporal Increase in the Incidence of Post-Transplantation Lymphoproliferative Disorder in Adult Renal Transplant Recipients: Analysis of 2 US Insurance Administrative Claims Databases [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/temporal-increase-in-the-incidence-of-post-transplantation-lymphoproliferative-disorder-in-adult-renal-transplant-recipients-analysis-of-2-us-insurance-administrative-claims-databases/. Accessed November 21, 2024.

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