Organ Transplants & Health Care

What are post-transplant lymphoproliferative disorders (PTLD)?

A Answers (1)

  • PTLDs occur when B-cell lymphocytes (white blood cells that are part of your immune system) multiply rapidly due to immunosuppressant medications that are taken to prevent organ rejection. The medications suppress the entire immune system and alter the normal regulation of B-cell production.

    When a person has a virus, the normal immune response is to produce more B-cells to fight the infection. The Epstein-Barr virus (EBV) is a virus that directly attacks B-cells and causes an overproduction of B-cells. In a healthy person the EBV infection is called mononucleosis, and the patient recovers from the virus by controlling B-cell production.

    When the donor and recipient are an EBV mismatch (in other words, you are negative for the virus and the donor is positive) you’re at greater risk of developing PTLD. In this situation you will be given an antiviral drug called acyclovir to prevent PTLD. If your child develops PLTD, the amount of immunosuppression medication is reduced to allow the immune system to recover and fight the overproduction of B-cells. However, decreasing your immunosuppression increases the risk of rejection. The usual signs and symptoms of EBV infection include fever, malaise, lymph node enlargement and liver and spleen enlargement.
This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.
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