Is hepatitis B virus reactivation a risk factor in the development of posttransplant lymphoproliferative disorder following liver transplantation?

Posttransplant lymphoproliferative disorder (PTLD) is a well-known complication of both solid organ and bone marrow transplantation, with a prevalence estimated to be between 1% to 20% depending on the type of organ transplanted.(1,2) PTLD includes a wide spectrum of proliferative changes ranging from reactive hyperplasia, borderline lesions, to malignant lymphomas. Several factors, such as the clinical immunosuppressive regimen, infection of the Epstein-Barr virus, and underlying disease in the patient are believed to contribute to the development of PTLD.3-5 In this report, we reviewed a consecutive series of 164 patients who underwent their first liver transplantation in our center. Three cases of PTLD were diagnosed on the basis of histological examination. All three patients had a background of hepatitis B virus (HBV) infection, and developed PTLD after an episode of HBV reactivation. Herein, we describe the clinical features of these three cases of PTLD, with particular reference to the potential association of HBV reactivation and development of PTLD.