Lymphoproliferative disorders after renal transplantation along 2 decades: a large longitudinal study of 21.546 recipients

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• dc.contributor.author Franco, Antonio
• dc.contributor.author Hernández, Domingo
• dc.contributor.author Zarraga, Sofia
• dc.contributor.author Sánchez Fructuoso, Ana
• dc.contributor.author Crespo Barrio, Marta
• dc.contributor.author Mazuecos, Auxiliadora
• dc.contributor.author Díaz-Corte, Carmen
• dc.contributor.author Rodríguez Benot, Alberto
• dc.contributor.author Ruiz, Juan Carlos
• dc.contributor.author Beneyto, Maria Isabel
• dc.date.accessioned 2024-05-10T05:51:45Z
• dc.date.available 2024-05-10T05:51:45Z
• dc.date.issued 2023
• dc.description Article disponible en castellà: http://hdl.handle.net/10230/60098
• dc.description.abstract Introduction: Post transplant lymphoproliferative disorders (PTLD) are heterogeneous lymphoid proliferations in recipients of solid organs which seem to be related to Epstein Barr Virus (EBV). The use of antilymphocyte antibodies, EBV seronegativity in the recipient,acute rejection and CMV infection have been identified as classical risk factors. Material y methods: We have studied in a retrospective observational study, the incidence of PTLD in a period of 22 years, its relationship with EBV, presence of classical risk factors and outcome in 21546 simple adult renal transplant recipients from cadaveric and living donors, transplanted in 21 hospitals from 1990 to 2009. Results: A total of 275 recipients developed PTLD (1,2%),195 males (70,9%), 80 females (29,1%) aged 59.2 (p25 44.7 p75 68)years. Two hundred forty-five (89.0%) were 1st transplant recipients and 269 (97,8%) from cadaveric donors. EBV in the tissue was reported in 94 out of the 155 studied recipients (60.6%) and 86.0% of the proliferations were due to B lymphocytes. PTLD median appearance after transplant were 42.months (p25, 75, 12, 77, 5). One hundred eighty-eight recipients out of 275 patients (68.3%) had any classical risk factor and the use of antilymphocyte antibodies was the most frequent. During the follow-up, 172 patients died (62,5%) and 103 (37,5%) had a complete remission. The main cause of death was PTLD progression (n = 91, 52,9%), followed by sepsis (n = 24, 13,9%). The follow-up period post-transplant of the recipients was between 3 and 22 years. The incidence was 0,14% during the first year post-trasplant and 0.98% the cumulative incidence at 10 years. Patient survival after diagnosis was 51%, 44% and 39% after 1, 2 and 5 years, respectively. Finally, overall graft survival was 48%, 39% and 33% at the same periods. Conclusion: PTLD has a low incidence in renal transplant recipients. Most of the proliferations are due to B lymphocytes and seem to have a close relationship with EBV. PTLD can develop in the absence of classical risk factors. The prognosis is poor, mainly due to PTLD progression, but the survivors can even maintain their grafts.
• dc.format.mimetype application/pdf
• dc.identifier.citation Franco A, Hernandez D, Zarraga S, Fructuoso AS, Crespo M, Mazuecos A, et al. Lymphoproliferative disorders after renal transplantation along 2 decades: a large longitudinal study of 21.546 recipients. Nefrologia (Engl Ed). 2023 Jul-Aug;43(4):427-34. DOI: 10.1016/j.nefroe.2023.09.001
• dc.identifier.doi http://dx.doi.org/10.1016/j.nefroe.2023.09.001
• dc.identifier.issn 2013-2514
• dc.identifier.uri http://hdl.handle.net/10230/60097
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Nefrologia (Engl Ed). 2023 Jul-Aug;43(4):427-34
• dc.rights © 2022 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Renal transplant recipient
• dc.subject.keyword Post-transplant
• dc.subject.keyword Lymphoproliferative disorders
• dc.subject.keyword Epstein-Barr virus
• dc.title Lymphoproliferative disorders after renal transplantation along 2 decades: a large longitudinal study of 21.546 recipients
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion