Post-transplant lymphoproliferative disorder following renal transplantation: a single-center experience over 40 years.
OBJECTIVE
To investigate post-transplant lymphoproliferative disorder (PTLD) following renal transplantation at our institution.


METHODS
Medical records of 631 patients who underwent renal transplantation at Osaka University Hospital between March 1965 and December 2008 were reviewed.


RESULTS
PTLD following renal transplantation was detected in 10 patients (five men, five women; mean age at transplantation, 38.5 years). Mean duration from renal transplantation to the onset of PTLD was 7.1 years (range, 5 months to 18 years, 9 months). Mean duration of observation was 3.9 years from the onset of PTLD. Immunosuppressant therapy comprised multidrug combination therapy, including cyclosporine in six patients and tacrolimus in four patients. In addition to a reduction in the immunosuppressant dose, which was performed in all patients, PTLD was treated with surgery in seven patients, radiotherapy in two patients, rituximab in five patients, and cytotoxic chemotherapy in four patients. A complete remission in eight patients and progressive disease in two were observed. At last follow up, seven patients were alive and five patients had functioning grafts.


CONCLUSIONS
The incidence of PTLD following renal transplantation at our institution is 1.6% with onset occurring more than 5 years after transplantation in five patients. Consequently, with long-term renal graft survival now feasible, attention must be paid to detecting late-onset PTLD.
Abe
Toyofumi
T
Department of Specific Organ Regulation (Urology), Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Ichimaru
Naotsugu
N
Kokado
Yukito
Y
Maeda
Tetsuo
T
Kakuta
Yoichi
Y
Okumi
Masayoshi
M
Imamura
Ryoichi
R
Nonomura
Norio
N
Isaka
Yoshitaka
Y
Takahara
Shiro
S
Okuyama
Akihiko
A
D000328:Adult; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000209:etiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D013997:Time Factors