Hossein Khedmat1, Saeed Taheri. 1. Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran. Khedmat.h@gmail.com
Abstract
BACKGROUND: Post-transplant lymphoproliferative disorders (PTLDs) can occur within the allograft, representing a differential diagnosis for an acute rejection episode; in this study, we collected data from PTLD patients involving kidney allografts, and compared their characteristics with other renal transplant patients from the same centers who developed PTLDs localized elsewhere. MATERIAL/ METHODS: A comprehensive search was made by Pubmed and Google Scholar for reports of lymphoproliferative disorders after renal transplantation. Data from 17 studies were included into analysis. Having at least 1 patient with renal allograft involvement by PTLD was inclusion criterion. Data for patients was collected by use of a standard questionnaire. RESULTS: PTLD complicated renal allograft in 46 (37%) of our study population. Renal transplant recipients with allograft localization of PTLD had better survival than other PTLD patients unless they developed multi-organ involvement (p=0.007). Five-year survival rate was 73% for graft PTLD and 42% for other localizations. Graft PTLD patients had shorter time from transplant to PTLD (p=0.01) and were more likely to present as polyclonal and polymorph in their histological evaluations (p<0.05). CONCLUSIONS: Renal transplant recipients who develop allograft dysfunction during the early post-transplantation period should get full evaluations for a potential PTLD development at their allograft site. Before development of multi-organ involvement allograft PTLD in renal transplant patients has a benign behavior; therefore it is crucial to evaluate renal recipients with initial symptoms of PTLDs.
BACKGROUND: Post-transplant lymphoproliferative disorders (PTLDs) can occur within the allograft, representing a differential diagnosis for an acute rejection episode; in this study, we collected data from PTLDpatients involving kidney allografts, and compared their characteristics with other renal transplant patients from the same centers who developed PTLDs localized elsewhere. MATERIAL/ METHODS: A comprehensive search was made by Pubmed and Google Scholar for reports of lymphoproliferative disorders after renal transplantation. Data from 17 studies were included into analysis. Having at least 1 patient with renal allograft involvement by PTLD was inclusion criterion. Data for patients was collected by use of a standard questionnaire. RESULTS:PTLD complicated renal allograft in 46 (37%) of our study population. Renal transplant recipients with allograft localization of PTLD had better survival than other PTLDpatients unless they developed multi-organ involvement (p=0.007). Five-year survival rate was 73% for graft PTLD and 42% for other localizations. Graft PTLDpatients had shorter time from transplant to PTLD (p=0.01) and were more likely to present as polyclonal and polymorph in their histological evaluations (p<0.05). CONCLUSIONS: Renal transplant recipients who develop allograft dysfunction during the early post-transplantation period should get full evaluations for a potential PTLD development at their allograft site. Before development of multi-organ involvement allograft PTLD in renal transplant patients has a benign behavior; therefore it is crucial to evaluate renal recipients with initial symptoms of PTLDs.
Authors: Rutger M van Ree; Aiko P J de Vries; Dorien M Zelle; Laura V de Vries; Leendert H Oterdoom; Reinold O B Gans; Jan P Schouten; Simon P M Lems; Willem J van Son; Stephan J L Bakker Journal: Med Sci Monit Date: 2011-11