title: Post-transplant Lymphoproliferative Disorder: A Single-Center Experience.
abstract: BACKGROUND
  Post-transplant lymphoproliferative disorder (PTLD) is the second most common neoplasia after adult kidney transplantation (KT).
  
  
  METHODS
  We retrospectively analyzed 8 adult patients who underwent KT in our center, diagnosed with PTLD between 2001 and 2014.
  
  
  RESULTS
  Six patients were men. The median age at presentation was 43 years and the median time since transplantation was 7.3 years. Three patients had previously received anti-thymocyte globulin/OKT3, and all were taking calcineurin inhibitors (CNI) at diagnosis. The monomorphic type was the most common, with diffuse large B-cell lymphoma as the origin. The most frequent presentation was fever. Four in five patients had Epstein-Barr-related PTLD. All patients received various regimens of immunosuppression reduction (IR), with 4 converting CNI to mTOR inhibitor (imTOR). Subsequent treatment (when needed) was chemotherapy, radiotherapy, and surgery. The maximum follow-up time was 6.7 years, with a 50% mortality rate that occurred at a median time of 3.5 months (2 died with functioning kidney). All 4 patients who were in remission at the end of follow-up had CNI conversion to imTOR, and none lost the allograft.
  
  
  CONCLUSIONS
  Despite the small number of cases, our results confirm the high PTLD impact in overall and allograft survival. Our PTLD type distribution is in accord with the literature. First-line PTLD treatment is IR, but the best method is still unknown; our results may suggest a beneficial effect of CNI conversion to imTOR.
authors.affiliation: Nephrology Department, Centro Hospitalar de São João, Porto, Portugal. Electronic address: ferreihugo@gmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Ferreira
authors.affiliation: Nephrology Department, Centro Hospitalar de São João, Porto, Portugal.
authors.forename: M
authors.initials: M
authors.lastname: Bustorff
authors.affiliation: Nephrology Department, Centro Hospitalar de São João, Porto, Portugal.
authors.forename: J
authors.initials: J
authors.lastname: Santos
authors.affiliation: Nephrology Department, Centro Hospitalar de São João, Porto, Portugal; Department of Renal, Urological and Infectious Diseases, Faculty of Medicine, University of Porto, Portugal.
authors.forename: I
authors.initials: I
authors.lastname: Ferreira
authors.affiliation: Nephrology Department, Centro Hospitalar de São João, Porto, Portugal; Department of Renal, Urological and Infectious Diseases, Faculty of Medicine, University of Porto, Portugal.
authors.forename: S
authors.initials: S
authors.lastname: Sampaio
authors.affiliation: Nephrology Department, Centro Hospitalar de São João, Porto, Portugal.
authors.forename: I
authors.initials: I
authors.lastname: Salomé
authors.affiliation: Clinical Hematology Department, Centro Hospitalar de São João, Porto, Portugal.
authors.forename: J
authors.initials: J
authors.lastname: Bastos
authors.affiliation: Clinical Hematology Department, Centro Hospitalar de São João, Porto, Portugal; Faculty of Medicine, University of Porto, Portugal.
authors.forename: R
authors.initials: R
authors.lastname: Bergantim
authors.affiliation: Clinical Hematology Department, Centro Hospitalar de São João, Porto, Portugal; Faculty of Medicine, University of Porto, Portugal.
authors.forename: F
authors.initials: F
authors.lastname: Príncipe
authors.affiliation: Nephrology Department, Centro Hospitalar de São João, Porto, Portugal; Department of Renal, Urological and Infectious Diseases, Faculty of Medicine, University of Porto, Portugal; Instituto Nacional de Engenharia Biomédica (INEB), Porto, Portugal.
authors.forename: M
authors.initials: M
authors.lastname: Pestana
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011174:Portugal / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014184:Transplantation, Homologous