Occurrence of lymphoproliferative disorder after heart transplantation is related to the total immunosuppressive load

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Abstract
Heart transplant recipients are at a high risk for the development of post‐transplant lymphoproliferative disorders (PTLD). We explored the relationship between the incidence of PTLD and the immunosuppressive therapy in 150 consecutive patients who received a cardiac transplant at our centre. None of our patients treated with cyclosporin A and prednisone only (n = 41) developed PTLD. In contrast, 6 of 101 patients who were previously treated with anti‐T‐cell preparations suffered from PTLD. No relationship was found between the type of anti‐T‐cell therapy and the incidence of PTLD. We conclude that the high incidence of PTLD in heart transplant recipients is related to the total immunosuppressive load and not related to a single agent like OKT3.