Resolution of renal allograft-associated post-transplant lymphoproliferative disorder with the introduction of sirolimus.

Lymphoid neoplasia has remained a serious complication following solid organ transplantation. Recent data suggest an 11.8-fold higher risk of lymphoma compared with the general population over a 10 year period [1]. Although the risk is greatest within the first year posttransplant, the incidence remains high throughout the entire post-transplant period. Risk factors include unrestrained proliferation of Epstein–Barr virus (EBV) and the overall immunosuppression burden [2,3]. Post-transplant lymphoproliferative disorder (PTLD) may also occur within the allograft and may be mistaken for acute rejection. The mTOR inhibitor sirolimus is currently under investigation as an antitumour agent, and its use as an immunosuppressive agent in solid organ transplants has been associated with a lower risk of post-transplant malignancies, including PTLD [4,5].