Characteristics and prognosis of post-transplant lymphoproliferative disorders within renal allograft: Report from the PTLD.Int. Survey.
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.


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.
Khedmat
Hossein
H
Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran. Khedmat.h@gmail.com
Taheri
Saeed
S
D000328:Adult; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008223:Lymphoma / Q000139:chemically induced / Q000150:complications / Q000209:etiology; D008232:Lymphoproliferative Disorders / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D019737:Transplants / Q000009:adverse effects