Preiksaitis and Keay identified risk factors associated with posttransplant lymphoproliferative disorder (PTLD). These can help identify patients who may benefit from closer monitoring and early therapy. The authors are from the University of Alberta and the University of Maryland.
Risk factors for posttransplant lymphoproliferative disorder:
(1) primary Epstein-Barr virus (EBV) infection or reactivation after the transplant
(2) infection with cytomegalovirus (CMV)
(3) donor with antibodies to CMV and recipient negative for antibodies to CMV (serologic mismatch)
(4) failure to receive prophylaxis to CMV
(5) severe immunosuppression, especially if OKT3 used
(6) viral hepatitis C (HCV) infection
(7) certain cytokine gene polymorphisms in the recipient (favoring viral infection)
These factors favor primary infection or reactivation of EBV, which can progress to the posttransplant lymphoproliferative disorder.
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