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Lymphoma after living donor kidney transplantation: an Iranian multicenter experience

  • Nephrology-Original Paper
  • Published:
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Abstract

Introduction

Post-transplant lymphoproliferative disorders (PTLD) are well-recognized complications in solid organ recipients. Limited data exist about the development of PTLDs in living kidney recipients. This study deals with a multicenter nationwide experience with kidney recipients from living donors.

Methods

We reviewed data of PTLD patients from a total population of 6,500 patients transplanted at three different transplant centers in Iran from 1984 to 2006. We also compared their data with 2,250 normal kidney recipients of Baqiyatallah Transplant Center. Data were analyzed to determine potential correlates with the occurrence of PTLD and patient outcome.

Results

Overall, 31 patients were diagnosed as having post-transplant lymphomas. The incidence of PTLD in our kidney transplant population comprised 0.47%. Sixteen (53%) PTLD patients were females, whereas 15 (47%) were males. The mean ages at transplantation and diagnosis were 37.1 and 41.9, respectively. Twelve (63%) patients died, and seven are alive. All deaths occurred within the 1st year after PTLD diagnosis. The mean time period from transplantation to diagnosis of PTLD was 64 (0.7–173) months. Localization of PTLD in the brain associated the worst outcome. Compared to non-PTLD patients, PTLD patients were significantly female predominated (51.6% vs. 32.2%; P = 0.03) and had lower age at transplantation (36.9 years vs. 42.9 years, respectively; P = 0.01). Patients under immunosuppressive regimens containing azathioprine were at higher risk for acquiring PTLDs compared to those with a MMF-containing regimen.

Conclusion

PTLD is a major threat to kidney transplant recipients. Immunosuppressive agents have a significant role in developing the disease. Early detection of the disease and using more safe immunosuppresants may have beneficial effects on patient outcomes and incidence of the disease.

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Abbreviations

PTLD:

Post-transplant lymphoproliferative disorder

EBV:

Epstein-Barr virus

CMV:

Cytomegalovirus

KTx:

Kidney transplant

ATG:

Antithymocyte globulin

ALG:

Antilymphocyte globulin

OKT-3:

Anti-T-cell receptor monoclonal antibody

AZA:

Azathioprine

MMF:

Cellcept: mycophenolate mofetil

CNS:

Central nervous system

GI:

Gastrointestinal

LUR:

Living unrelated

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Authors and Affiliations

  1. Nephrology and Urology Research Center, Baqiyatallah Hospital, Mullasadra St., 14155-6437, 1435915371, Tehran, Iran

    Vahid Pourfarziani, Saeed Taheri, Mahboob Lessan-Pezeshki, Mohammad Hossein Nourbala, Eghlim Nemati, Khadijeh Makhdoomi, Ali Ghafari, Pedram Ahmadpour & Behzad Einollahi

  2. Baqiyatallah University of Medical Sciences, Tehran, Iran

    Vahid Pourfarziani, Mohammad Hossein Nourbala, Eghlim Nemati & Behzad Einollahi

  3. Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Naser Simforoosh & Mohsen Nafar

  4. Urmia University of Medical Sciences, Urmia, Iran

    Khadijeh Makhdoomi, Ali Ghafari & Pedram Ahmadpour

Authors
  1. Vahid Pourfarziani
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  2. Saeed Taheri
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  3. Mahboob Lessan-Pezeshki
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  4. Mohammad Hossein Nourbala
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  5. Naser Simforoosh
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  6. Eghlim Nemati
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  7. Khadijeh Makhdoomi
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  8. Ali Ghafari
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  9. Pedram Ahmadpour
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  10. Mohsen Nafar
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  11. Behzad Einollahi
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Corresponding author

Correspondence to Vahid Pourfarziani.

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Pourfarziani, V., Taheri, S., Lessan-Pezeshki, M. et al. Lymphoma after living donor kidney transplantation: an Iranian multicenter experience. Int Urol Nephrol 40, 1089–1094 (2008). https://doi.org/10.1007/s11255-008-9377-0

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  • DOI: https://doi.org/10.1007/s11255-008-9377-0

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