title: Simultaneous development of lymphoma in recipients of renal transplants from a single donor: donor origin confirmed by human leukocyte antigen staining and microsatellite analysis.
abstract: BACKGROUND
  Posttransplant lymphoproliferative disorders (PTLD) occur in 0.5% to 2.5% of cases in renal-transplant recipients. Epstein-Barr virus (EBV) is usually detected in the tumor cells, suggesting a role for this virus as an agent of B-cell proliferation. It is unusual for patients receiving allografts from the same donor to develop PTLD simultaneously.
  
  
  METHODS
  we describe two patients who received renal allografts from the same donor and developed PTLD simultaneously. The presence of EBV in both tumors was confirmed. In this report, the origin of tumor cells was determined by immunohistochemical human leukocyte antigen (HLA) typing and microsatellite analysis. Clonality was studied by immunoglobulin gene rearrangement analysis.
  
  
  RESULTS
  Our results suggest that the tumor originated from donor cells in both patients but, because immunoglobulin gene rearrangements were different, this could mean that lymphoid cells proliferate independently in each recipient.
  
  
  CONCLUSIONS
  We propose the following pathogenesis: immortalization of passenger B lymphocytes by EBV, proliferation of these cells, and development of PTLD by means of immunosuppression, antigenic stimulation, and HLA mismatch.
authors.affiliation: Department of Nephrology and Transplantation, Hôpitaux Universitaires de Strasbourg, France. sophie.caillard@chru-strasbourg.fr
authors.forename: Sophie
authors.initials: S
authors.lastname: Caillard
authors.forename: Erwan
authors.initials: E
authors.lastname: Pencreach
authors.forename: Laura
authors.initials: L
authors.lastname: Braun
authors.forename: Luc
authors.initials: L
authors.lastname: Marcellin
authors.forename: Marie-Lorraine Woehl
authors.initials: ML
authors.lastname: Jaegle
authors.forename: Philippe
authors.initials: P
authors.lastname: Wolf
authors.forename: Anne
authors.initials: A
authors.lastname: Parissiadis
authors.forename: Thierry
authors.initials: T
authors.lastname: Hannedouche
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Gaub
authors.forename: Bruno
authors.initials: B
authors.lastname: Moulin
mesh_terms: D000328:Adult; D005260:Female; D015321:Gene Rearrangement; D005803:Genes, Immunoglobulin; D006680:HLA Antigens / Q000032:analysis*; D006801:Humans; D007150:Immunohistochemistry; D016030:Kidney Transplantation / Q000009:adverse effects*; D008223:Lymphoma / Q000209:etiology*; D008297:Male; D018895:Microsatellite Repeats; D008875:Middle Aged; D014019:Tissue Donors
chemical_list: D006680:HLA Antigens