title: An approach to finding indications and contraindications for nephrectomy in post-transplant renal graft lymphomas: PTLD.Int survey.
abstract: OBJECTIVE
  Allograft involvement can occur in some renal transplant recipients who develop post-transplant lymphoproliferative disorders (PTLD). We aimed to find indications and/or contraindications for nephrectomy in renal allograft PTLD based on an outcome analysis of previous reports.
  
  
  METHODS
  A comprehensive search of Pubmed and Google scholar was performed to find reports of different treatment strategies addressing PTLD occurring within the allograft after renal transplantation.
  
  
  METHODS
  Patients who underwent nephrectomy due to kidney allograft localization by PTLD were categorized as the case group, and renal recipients with kidney PTLD for whom nonsurgical treatment modalities were used served as controls.
  
  
  RESULTS
  Survival analysis demonstrated that patients with renal allograft involvement who underwent allograft nephrectomy had a significantly better outcome compared to patients for whom a non-surgical approach was used (P=.03). In patients with disseminated PTLD, nephrectomy was not useful (P>.1). Patients with simultaneous kidney and lung complications by PTLD benefitted from nephrectomy.
  
  
  CONCLUSIONS
  We found that patients with renal graft complication with disseminated PTLD do not benefit from nephrectomy, which can be considered the only contraindication. However, some particular PTLD co-localizations were not as likely to adversely affect the benefit of nephrectomy in these patients, and these can be considered indications for the procedure. Future multicenter studies are needed to confirm our results.
authors.affiliation: Guilan University of Medical Sciences, Rasht, Iran. qolipor@gmail.com
authors.forename: A
authors.initials: A
authors.lastname: Gholipour-Shoiili
authors.forename: H
authors.initials: H
authors.lastname: Gholipour-Shoiili
authors.forename: S
authors.initials: S
authors.lastname: Taheri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D016030:Kidney Transplantation; D008223:Lymphoma / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D016019:Survival Analysis; D014184:Transplantation, Homologous
chemical_list: D007166:Immunosuppressive Agents