TY - JOUR
T1 - Associations between EBV serostatus and organ transplant type in PTLD risk
T2 - An analysis of the SRTR national registry data in the United States
AU - Dharnidharka, Vikas R.
AU - Lamb, K. E.
AU - Gregg, J. A.
AU - Meier-Kriesche, H. U.
PY - 2012/4
Y1 - 2012/4
N2 - 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.
AB - 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.
KW - Epstein-Barr virus
KW - Heart transplant
KW - Kidney transplant
KW - Liver transplant
KW - PTLD
UR - http://www.scopus.com/inward/record.url?scp=84859311382&partnerID=8YFLogxK
U2 - 10.1111/j.1600-6143.2011.03893.x
DO - 10.1111/j.1600-6143.2011.03893.x
M3 - Article
C2 - 22226225
AN - SCOPUS:84859311382
SN - 1600-6135
VL - 12
SP - 976
EP - 983
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 4
ER -