Clinical characteristics and outcomes of PTLD following intestinal transplantation

Laura J. Wozniak, Tian L. Mauer, Robert S. Venick, Jonathan W. Said, Roy L. Kao, Pamela Kempert, Elizabeth A. Marcus, Vilayphone Hwang, Elaine Y. Cheng, Ronald W. Busuttil, Sue V. McDiarmid, Douglas G. Farmer

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6 Scopus citations


Post-transplant lymphoproliferative disease (PTLD) has the highest incidence following intestinal transplantation (ITx). Our center has seen a recent increase in PTLD. Our aim was to review a single-center PTLD experience with a focus on clinical characteristics and outcomes. We completed a retrospective review of biopsy-proven PTLD cases using a prospectively maintained database of 115 ITx recipients transplanted between 1991 and 2014. Nineteen (17%) ITx recipients developed 25 PTLD cases during a median follow-up time of 6.4 (1.6-14.6) years. The incidence of early PTLD was 6% (n = 7). There was a trend toward increased risk of PTLD in children compared with adults (P =.11) and a significantly increased risk of PTLD in re-ITx compared with primary ITx recipients (P =.03). Most PTLD cases were diagnosed between 2010 and 2014 (n = 14). All early PTLD cases were EBV+ on in situ hybridization. Overall graft and patient survival are 68% and 74%, respectively. Second episodes of PTLD were diagnosed in 43% of surviving pediatric patients. Our program has a low incidence of early PTLD with overall excellent graft and patient survival following diagnosis. However, we have also seen a rising incidence of late PTLD. The cause of the increase is unknown as no major changes in immunosuppression protocols have occurred since 1999.

Original languageEnglish (US)
Article numbere13313
JournalClinical Transplantation
Issue number8
StatePublished - Aug 2018
Externally publishedYes


  • Epstein-Barr virus
  • intestinal transplantation
  • post-transplant lymphoproliferative disease


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