Post‐transplant lymphoproliferative disorder after pancreas transplantation: a United Network for Organ Sharing database analysis

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 .