What is posttransplant lymphoproliferative disease (PTLD) and how is it managed?

Updated: Jan 04, 2016
  • Author: Bethany Pellegrino, MD; Chief Editor: Mary C Mancini, MD, PhD, MMM  more...
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Answer

Answer

Posttransplant lymphoproliferative disease (PTLD) is a growing concern in the transplant population. Most of these are of B-cell origin and linked to EBV infections. Patients present with constitutional symptoms such as night sweats, fevers, and weight loss. An acute rise in creatinine levels, similar to acute allograft rejection, may also be seen. Risk factors for PTLD include primary EBV infection; [20] the use of cyclosporine, tacrolimus, and MMF; and an exposure to antithymocyte globulin (ATG) or OKT3. Treatment options include reduction or discontinuation of immunosuppression with an increase in prednisone to reduce rejection risk. [20] Further studies involving the efficacy of sirolimus and rituximab are needed to determine their specific role.


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