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Post‐transplant lymphoproliferative disorder after pancreas transplantation: a United Network for Organ Sharing database analysis
Author(s) -
Jackson K.,
Ruppert K.,
Shapiro R.
Publication year - 2013
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12252
Subject(s) - medicine , pancreas transplantation , united network for organ sharing , transplantation , proportional hazards model , gastroenterology , organ transplantation , univariate analysis , immunosuppression , tacrolimus , regimen , complication , pancreas , database , multivariate analysis , liver transplantation , kidney transplantation , computer science
There are not a great deal of data on post‐transplant lymphoproliferative disorder ( PTLD ) following pancreas transplantation. We analyzed the United Network for Organ Sharing national database of pancreas transplants to identify predictors of PTLD development. A univariate Cox model was generated for each potential predictor, and those at least marginally associated (p < 0.15) with PTLD were entered into a multivariable Cox model. PTLD developed in 43 patients (1.0%) of 4205 pancreas transplants. Mean follow‐up time was 4.9 ± 2.2 yr. In the multivariable Cox model, recipient EBV seronegativity ( HR 5.52, 95% CI : 2.99–10.19, p < 0.001), not having tacrolimus in the immunosuppressive regimen ( HR 6.02, 95% CI : 2.74–13.19, p < 0.001), recipient age ( HR 0.96, 95% CI : 0.92–0.99, p = 0.02), non‐white ethnicity ( HR 0.11, 95% CI : 0.02–0.84, p = 0.03), and HLA mismatching ( HR 0.80, 95% CI : 0.67–0.97, p = 0.02) were significantly associated with the development of PTLD . Patient survival was significantly decreased in patients with PTLD , with a one‐, three‐, and five‐yr survival of 91%, 76%, and 70%, compared with 97%, 93%, and 88% in patients without PTLD (p < 0.001). PTLD is an uncommon but potentially lethal complication following pancreas transplantation. Patients with the risk factors identified should be monitored closely for the development of PTLD .