Post-Transplant Lymphoproliferative Disorder (PTLD)

Lymphoproliferative complication after solid organ and stem cell transplantation.

Written by: Saygı Hospital Health Guide Editorial Board

Last updated: June 11, 2026

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Post-Transplant Lymphoproliferative Disorder (PTLD)?

Post-transplant lymphoproliferative disorder (PTLD) is a heterogeneous group of lymphoproliferations that occurs in transplant recipients due to immunosuppression. Most cases (>80%) are associated with Epstein-Barr virus (EBV).

WHO 2017 classification categorises PTLD as non-destructive, polymorphic, monomorphic and classical Hodgkin-like. Time of occurrence (early/late) and primary EBV infection at time of transplantation are determining factors.

Symptoms

Lymphadenopathy (cervical, mediastinal, abdominal)

Constitutional symptoms (fever, night sweats, weight loss)

Extranodal involvement (GI, CNS, transplanted organ)

Allograft dysfunction (in transplanted organ)

Tonsillar hypertrophy (in childhood PTLD)

EBV-DNA elevation

Risk Factors

EBV serostatus mismatch (D+/R-)

Childhood transplant (primary EBV infection)

Strong induction therapy (ATG, OKT3, alemtuzumab)

Lung and intestinal transplantation (highest risk)

Recipient age

Acute rejection episodes

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

New lymphadenopathy in transplant recipient
Persistent fever and B symptoms
Allograft dysfunction with extranodal mass
EBV-DNA elevation (>100,000 copies/mL)
Transplant patient with weight loss

Treatment Methods

Excisional biopsy and immunophenotyping (CD20)

PET/CT (staging)

Reduction of immunosuppression (RIS - first step)

Rituximab monotherapy (in CD20+ B-cell PTLD)

R-CHOP chemotherapy (in monomorphic, aggressive cases)

EBV-specific cytotoxic T-cell therapy (in selected cases)

EBV-DNA monitoring (early detection)

Surgery and radiotherapy (in localised cases)

Multidisciplinary approach (transplant + haematology + oncology)

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Dahiliye (İç Hastalıkları) Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.