Rising incidence of post-transplant lymphoproliferative disease in kidney transplant recipients

Background: The purpose of this study was to determine whether the incidenc e of post-transplant lymphoproliferative disease (PTLD) has been increasing in renal transplant recipients in this centre. Methods: Prospectively gathered data were analysed to establish trends in t he epidemiology of PTLD in 1537 patients. Results: Overall, PTLD occurred in 2.3 per cent of renal transplant recipie nts. An increase in its incidence coincided with the introduction of cyclos porin in the 1980s. However, there was a further increase in the incidence of PTLD in the 1990s when the only change in immunosuppressive policy was t he abandonment of pretransplantation blood transfusion. The latter increase was particularly pronounced in patients with early-onset PTLD in whom it p resented within 600 days after transplantation. Conclusion: The incidence of PTLD has been increasing in renal transplant r ecipients. The recent increase appears to be independent of cyclosporin and may reflect the reduction in pretransplant blood transfusion. Changes in t he incidence of PTLD may also mirror changes in the epidemiology of non-Hod gkin lymphoma in the general population.