Post-Transplant Lymphoproliferative Disorder Which Developed 45 Years After Kidney Transplantation

Post-transplant lymphoproliferative disorder (PTLD) affects from 0.8-2.5% of kidney transplant patients, with peaks in incidence within 1 year and 10-14 years post-transplant. Very late-onset PTLD (VL-PTLD) can occur over 10 years post-transplant, reportedly up to 30 years, but its characteristics remain unclear. A 61-year-old man developed PTLD 45 years after kidney transplant, presenting with fever and shortness of breath. Computed tomography revealed lung and liver masses and biopsy-confirmed stage IVB monomorphic PTLD. Despite obtaining an initial improvement, the patient died on day 66. VL-PTLD may differ from early- or late-onset PTLD, thus necessitating further research on both the associated risks and management.