BACKGROUND AND OBJECTIVES: Post-transplant lymphoproliferative disorders arising after kidney transplantation portend an increased risk of morbidity and mortality. Retransplantation of patients who had developed post-transplant lymphoproliferative disorder remains questionable owing to the potential risks of recurrence when immunosuppression is reintroduced. Here, we investigated the feasibility of kidney retransplantation after the development of post-transplant lymphoproliferative disorder. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We reviewed the data from all patients who underwent kidney retransplantation after post-transplant lymphoproliferative disorder in all adult kidney transplantation centers in France between 1998 and 2015. RESULTS: We identified a total of 52 patients with kidney transplants who underwent 55 retransplantations after post-transplant lymphoproliferative disorder. The delay from post-transplant lymphoproliferative disorder to retransplantation was 100±44 months (28-224); 98% of patients were Epstein-Barr virus seropositive at the time of retransplantation. Induction therapy for retransplantation was used in 48 patients (i.e., 17 [31%] patients received thymoglobulin, and 31 [57%] patients received IL-2 receptor antagonists). Six patients were also treated with rituximab, and 53% of the patients received an antiviral drug. The association of calcineurin inhibitors, mycophenolate mofetil, and steroids was the most common maintenance immunosuppression regimen. Nine patients were switched from a calcineurin inhibitor to a mammalian target of rapamycin inhibitor. One patient developed post-transplant lymphoproliferative disorder recurrence at 24 months after retransplantation, whereas post-transplant lymphoproliferative disorder did not recur in 51 patients. CONCLUSIONS: The recurrence of post-transplant lymphoproliferative disorder among patients who underwent retransplantation in France is a rare event.
BACKGROUND AND OBJECTIVES: Post-transplant lymphoproliferative disorders arising after kidney transplantation portend an increased risk of morbidity and mortality. Retransplantation of patients who had developed post-transplant lymphoproliferative disorder remains questionable owing to the potential risks of recurrence when immunosuppression is reintroduced. Here, we investigated the feasibility of kidney retransplantation after the development of post-transplant lymphoproliferative disorder. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We reviewed the data from all patients who underwent kidney retransplantation after post-transplant lymphoproliferative disorder in all adult kidney transplantation centers in France between 1998 and 2015. RESULTS: We identified a total of 52 patients with kidney transplants who underwent 55 retransplantations after post-transplant lymphoproliferative disorder. The delay from post-transplant lymphoproliferative disorder to retransplantation was 100±44 months (28-224); 98% of patients were Epstein-Barr virus seropositive at the time of retransplantation. Induction therapy for retransplantation was used in 48 patients (i.e., 17 [31%] patients received thymoglobulin, and 31 [57%] patients received IL-2 receptor antagonists). Six patients were also treated with rituximab, and 53% of the patients received an antiviral drug. The association of calcineurin inhibitors, mycophenolate mofetil, and steroids was the most common maintenance immunosuppression regimen. Nine patients were switched from a calcineurin inhibitor to a mammalian target of rapamycin inhibitor. One patient developed post-transplant lymphoproliferative disorder recurrence at 24 months after retransplantation, whereas post-transplant lymphoproliferative disorder did not recur in 51 patients. CONCLUSIONS: The recurrence of post-transplant lymphoproliferative disorder among patients who underwent retransplantation in France is a rare event.
Authors: Bertram L Kasiske; Aleksandra Kukla; Dolca Thomas; Jennifer Wood Ives; Jon J Snyder; Yang Qiu; Yi Peng; Vikas R Dharnidharka; Ajay K Israni Journal: Am J Kidney Dis Date: 2011-09-17 Impact factor: 8.860
Authors: D E Tsai; C L Hardy; J E Tomaszewski; R M Kotloff; K M Oltoff; B G Somer; S J Schuster; D L Porter; K T Montone; E A Stadtmauer Journal: Transplantation Date: 2001-04-27 Impact factor: 4.939
Authors: W J F M van der Velden; T Mori; W B C Stevens; A F J de Haan; F F Stelma; N M A Blijlevens; J P Donnelly Journal: Bone Marrow Transplant Date: 2013-06-10 Impact factor: 5.483
Authors: S Caillard; F X Lamy; C Quelen; J Dantal; Y Lebranchu; P Lang; M Velten; B Moulin Journal: Am J Transplant Date: 2012-01-06 Impact factor: 8.086
Authors: C D Wimmer; M Rentsch; A Crispin; W D Illner; H Arbogast; C Graeb; K-W Jauch; M Guba Journal: Kidney Int Date: 2007-02-28 Impact factor: 10.612
Authors: Kira Endén; Juuso Tainio; Atte Nikkilä; Ilkka Helanterä; Arno Nordin; Mikko P Pakarinen; Hannu Jalanko; Kirsi Jahnukainen; Timo Jahnukainen Journal: Pediatr Nephrol Date: 2020-05-11 Impact factor: 3.714