Author/Authors :
Einollahi, Behzad Nephrology Research Center, Baqiyatallah University of Medical Sciences, , Lessan-Pezeshki, Mahboob Department of Nephrology - Tehran University of Medical Sciences , Nourbala, Mohammad Hossein Nephrology Research Center, Baqiyatallah University of Medical Sciences, , Simforoosh, Nasser Department of Kidney Transplant - Shahid Beheshti University , Pourfarziani , Vahid Nephrology Research Center, Baqiyatallah University of Medical Sciences, , Nemati, Eghlim Nephrology Research Center, Baqiyatallah University of Medical Sciences, , Mohsen, Nafar Department of Kidney Transplant - Shahid Beheshti University , Basiri, Abbas Department of Kidney Transplant - Shahid Beheshti University , Pour Reza Gholi, Fatemeh Department of Kidney Transplant - Shahid Beheshti University , Firoozan, Ahmad Department of Kidney Transplant - Shahid Beheshti University , Ghadiani, Mohammad Hassan Nephrology Research Center - Baqiyatallah University of Medical Sciences , Makhdoomi, Khadijeh Department of Nephrology - Urmia University of Medical Sciences , Ghafari, Ali Department of Nephrology - Urmia University of Medical Sciences , Ahmadpour, Pedram Department of Kidney Transplant - Shahid Beheshti University , Oliaei, Farshid Department of Nephrology - Babol University of Medical Sciences , Ardalan, Mohammad Reza Department of Nephrology - Tabriz University of Medical Sciences , Makhlough, Atieh Department of Nephrology - Sari University of Medical Sciences , Samimagham, Hamid Reza Department of Nephrology - Hormozgan University of Medical Sciences , Azmandian, Jalal Department of Nephrology - Kerman University of Medical Sciences , Razeghi, Efat Department of Nephrology - Tehran University of Medical Sciences , Shahbazian, Heshmatollah Department of Nephrology - Ahwaz University of Medical Sciences
Abstract :
Introduction. Limited data with adequate sample size exist on the
development of posttransplant lymphoproliferative disorder (PTLD)
in living donor kidney recipients. We conducted a retrospective
cohort study on the data of 10 transplant centers to identify the
incidence of PTLD in Iran.
Materials and Methods. Data of 9917 kidney transplant recipients
who received their kidneys between 1984 and 2008 were reviewed.
Fifty-one recipients (0.5%) who developed PTLD were evaluated with
a median follow-up of 47.5 months (range, 1 to 211) months.
Results. Patients with PTLD represented 24% of all posttransplant
malignancies (51 out of 211 cases). There was no relationship
between PTLD and sex (P = .20). There were no statistically
significance differences considering the age at transplantation
between patients with and without PTLD. The late-onset PTLD
(70.6%) occurred more frequently compared to the early form.
There was no signification relationship between early-onset and
late-onset groups in terms of clinical course and outcome. In
patients who received azathioprine, PTLD was more frequent
when compared to those who received mycophenolate mofetil
(P < .001). The lymph nodes were the predominantly involved
site (35.3%), followed by the gastrointestinal tract, brain, kidney
allograft, lung, ovary, vertebrae, and palatine. Age at diagnosis
and the time from transplantation to diagnosis were comparable
for various involvement sites of PTLDs. The overall mortality in
this series of patients was 51.0%.
Conclusions. Posttransplant lymphoproliferative disorder is a
rare but devastating complication and long-term prognosis can be
improved with early recognition and appropriate therapy.
