Associations Between EBV Serostatus and Organ Transplant Type in PTLD Risk: An Analysis of the SRTR National Registry Data in the United States

In a prior multiorgan transplant database study, recipient Epstein–Barr virus (EBV) seronegativity was not associated with increased risk for posttransplant lymphoproliferative disorders (PTLD) in liver transplants (LTX), at variance with prior single center reports and with data from kidney and hea...

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Bibliographic Details
Published in:	American journal of transplantation 2012-04, Vol.12 (4), p.976-983
Main Authors:	Dharnidharka, V. R., Lamb, K. E., Gregg, J. A., Meier‐Kriesche, H.‐U.
Format:	Article
Language:	eng
Subjects:	Adolescent Biological and medical sciences Epstein-Barr virus Epstein-Barr Virus Infections - blood Epstein-Barr Virus Infections - epidemiology Epstein-Barr Virus Infections - etiology Female Follow-Up Studies heart transplant Hematologic and hematopoietic diseases Herpesvirus 4, Human - pathogenicity Humans Infectious diseases kidney transplant Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis liver transplant Lymphoma - complications Lymphoma - therapy Lymphoma - virology Lymphoproliferative Disorders - epidemiology Lymphoproliferative Disorders - etiology Lymphoproliferative Disorders - mortality Male Medical sciences PTLD Registries Risk Factors Seroepidemiologic Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Survival Rate Transplants - adverse effects United States - epidemiology Viral diseases
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Summary:	In a prior multiorgan transplant database study, recipient Epstein–Barr virus (EBV) seronegativity was not associated with increased risk for posttransplant lymphoproliferative disorders (PTLD) in liver transplants (LTX), at variance with prior single center reports and with data from kidney and heart transplants (KTX and HTX). The Scientific Registry of Transplant Recipients (SRTR) in the United States is the only other registry with data on the required variables for comparison.Our study set comprised 112 756 KTX (580 PTLDs; 0.51%), 13 937 HTX (140 PTLDs; 1.0%) and 40 437 LTX (383 PTLDs; 0.95%) performed January 2003 onward. The unadjusted hazard ratio (HR) for PTLD if recipient EBV seronegative was 5.005 for KTX, 6.528 for HTX and 2.615 for LTX (p < 0.001 for all). In models adjusted for multiple covariates, the adjusted HR was 3.583 (p < 0.001) for KTX, 4.037 (p < 0.001) for HTX, 1.479 (p = 0.03) for LTX. Interaction models using EBV seropositive KTX as reference group showed significantly higher risk for all other EBV seronegative organ transplant groups and also for EBV seropositive LTX (AHR 2.053, p < 0.0001).Recipient EBV seronegativity is still significantly associated with risk for PTLD in LTX, though less so because of higher baseline risk in the EBV seropositive LTX group. In this analysis of the United States Scientific Registry for Transplant Recipients database, Epstein‐Barr virus seronegative liver transplant recipients had a significantly higher risk for posttransplant lymphoproliferative disorders compared to seropositive recipients, contradicting previously published results from a European database, the Collaborative Transplant Study.
ISSN:	1600-6135 1600-6143