scholarly journals Post-transplant lymphoproliferative disorder following kidney transplantation: a population-based cohort study

2016 ◽  
Vol 29 (4) ◽  
pp. 483-493 ◽  
Author(s):  
Eva Futtrup Maksten ◽  
Maja Ølholm Vase ◽  
Jan Kampmann ◽  
Francesco d'Amore ◽  
Michael Boe Møller ◽  
...  
Keyword(s):  
Cohort Study ◽  
Kidney Transplantation ◽  
Lymphoproliferative Disorder ◽  
Population Based ◽  
Post Transplant

Mortality after pediatric kidney transplantation in England - a population-based cohort study

2013 ◽  
Vol 18 (1) ◽  
pp. 16-22 ◽  
Author(s):  
Daniela Farrugia ◽  
James Cheshire ◽  
Sophia Mahboob ◽  
Irena Begaj ◽  
Sajan Khosla ◽  
...  
Keyword(s):  
Cohort Study ◽  
Kidney Transplantation ◽  
Population Based ◽  
Pediatric Kidney Transplantation

Prevalence of Post-Transplant Lymphoproliferative Disorder with Monoclonal Gammopathy of Unknown Significance in Patients Undergoing Kidney Transplantation.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4778-4778
Author(s):  
Harris V.K. Naina ◽  
Robert Kyle ◽  
Thomas M. Habermann ◽  
Samar Harris ◽  
Fernando G. Cosio ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Kidney Transplantation ◽  
T Cell ◽  
Organ Transplantation ◽  
Monoclonal Gammopathy ◽  
Lymphoproliferative Disorder ◽  
M Protein ◽  
Monoclonal Protein ◽  
Post Transplant

Abstract Background: Post-transplant lymphoproliferative disorder (PTLD) represents one of the most serious consequences of immunosuppression in patients with solid organ transplantation. The incidence of PTLD is related to the organ transplanted and is dependent on the duration of follow-up. In various publications, the incidence of PTLD in renal transplantation ranges between 0.8% to 1.2%. In a previous study, the development of monoclonal (M) protein following liver transplantation is associated with the development of PTLD. In this study, we investigate this relationship in the kidney transplant population. Methods: A total of 3518 patients underwent kidney transplantation between 1963 to March 2006. These patients were cross referenced with the Monoclonal Gammopathy of Undetermined Significance (MGUS) database. Results: We identified 97 patients who had a monoclonal gammopathy either before or after transplantation. Patients with amyloidosis, multiple myeloma, heavy and light chain deposition disease and multi-organ transplantation were excluded from the analysis. A total of 69 patients met the inclusion criteria. Ten of the 69 (14.5%) patients developed PTLD. Median follow-up was 14.8 years. Twenty three patients had pretransplant MGUS, 20 patients developed MGUS following the transplant, and the other 26 did not have a monoclonal protein study prior to the transplant. Of the 23 patients who had a positive MGUS prior to the transplant, 4 patients (17.3%) developed PTLD, 1 patient developed EBV positive diffuse large cell lymphoma (DLCL), 1 developed EBV negative DLCL, 1 developed Hodgkin’s lymphoma and 1 developed increased plasma cells in bone marrow (20%) with stable M protein with no evidence of progression to multiple myeloma. None of these patients had a quantifiable M-protein prior to transplantation. The mean duration from diagnosis of MGUS to PTLD was 8.2 years (range 3 to 14 years). Of the 20 patients with a negative pre-transplant study for para proteniemia, 2 (10%) developed PTLD (T cell lymphoproliferative disorder). Two patients developed MGUS after the transplant at 1 and 12 years post transplant. It took an average of 15 years to develop PTLD after the diagnosis of MGUS. Four of the 26 patients who did not have a pretransplant study for MGUS developed PTLD. These included an EBV positive gamma delta type T cell lymphoproliferative disorder, an EBV positive plasmablastic lymphoma, one multiple myeloma and a plasmacytoma. The latter two patients had M-protein > 3g/dL. It took an average of 14 years after their transplant for these patients to develop PTLD. Conclusion: Our study showed that the development of a monoclonal protein in patients undergoing kidney transplantation is a strong risk factor for PTLD. Monoclonal protein study should be performed pretransplant and monitored post transplant as a surveillance of PTLD. Those who are positive or convert should be monitored closely for development of lymphoproliferative disorder.

scholarly journals Pre-Transplant Plasma Potassium as a Potential Risk Factor for the Need of Early Hyperkalaemia Treatment after Kidney Transplantation: A Cohort Study

Nephron ◽  
2020 ◽  
Vol 145 (1) ◽  
pp. 63-70
Author(s):  
Bram C.S. de Vries ◽  
Stefan P. Berger ◽  
Stephan J.L. Bakker ◽  
Martin H. de Borst ◽  
Margriet F.C. de Jong
Keyword(s):  
Regression Analysis ◽  
Cohort Study ◽  
Kidney Transplantation ◽  
Renal Transplantation ◽  
Multivariate Logistic Regression Analysis ◽  
Plasma Potassium ◽  
Renal Transplant Recipients ◽  
Cardiac Events ◽  
Post Transplant ◽  
Increased Risk

<b><i>Introduction:</i></b> Plasma potassium (K<sup>+</sup>) abnormalities are common among patients with chronic kidney disease and are associated with higher rates of death, major adverse cardiac events, and hospitalization in this population. Currently, no guidelines exist on how to handle pre-transplant plasma K+ in renal transplant recipients (RTR). <b><i>Objective:</i></b> The aim of this study is to examine the relation between pre-transplant plasma K<sup>+</sup> and interventions to resolve hyperkalaemia within 48 h after kidney transplantation. <b><i>Methods:</i></b> In a single-centre cohort study, we addressed the association between the last available plasma K<sup>+</sup> level before transplantation and the post-transplant need for dialysis or use of K<sup>+</sup>-lowering medication to resolve hyperkalaemia within 48 h after renal transplantation using multivariate logistic regression analysis. <b><i>Results:</i></b> 151 RTR were included, of whom 51 (33.8%) patients received one or more K<sup>+</sup> interventions within 48 h after transplantation. Multivariate regression analysis revealed that a higher pre-transplant plasma K<sup>+</sup> was associated with an increased risk of post-transplant intervention (odds ratio 2.2 [95% CI: 1.1–4.4]), independent of donor type (deceased or living) and use of K<sup>+</sup>-lowering medication within 24 h prior to transplantation). <b><i>Conclusions:</i></b> This study indicates that a higher pre-transplant plasma K<sup>+</sup> is associated with a higher risk of interventions necessary to resolve hyperkalaemia within 48 h after renal transplantation. Further research is recommended to determine a cutoff level for pre-transplant plasma K<sup>+</sup> that can be used in practice.

scholarly journals Early post-transplant lymphoproliferative disorder - case of fatal lymphoma after kidney transplantation

2016 ◽  
Vol 144 (5-6) ◽  
pp. 325-328 ◽  
Author(s):  
Mirjana Lausevic ◽  
Jasmina Markovic-Lipkovski ◽  
Tatjana Terzic ◽  
Natasa Jovanovic ◽  
Marija Milinkovic ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
B Cell ◽  
Lymphoproliferative Disorder ◽  
Cell Lymphoma ◽  
Left Kidney ◽  
B Cell Lymphoma ◽  
Sudden Onset ◽  
Immunosuppressive Regimen ◽  
Post Transplant ◽  
Native Kidney

Introduction. Post-transplant lymphoproliferative disorder (PTLD) is a common malignancy following organ transplantation. Risk for PTLD is associated with the use of anti-thymocyte globulin in the prevention and treatment of acute rejection following kidney transplantation. Case Outline. We report a case of fatal PTLD presented with sudden onset of fever. A 33-year-old male patient with primary diagnosis of left kidney agenesia underwent kidney transplantation six years following hemodialysis treatment initiation. Deceased donor was a 66-year-old female whose cause of death was cerebrovascular accident. Immunosuppressive regimen consisted of basiliximab, corticosteroids, tacrolimus, and mycophenolate mofetil. Six months upon transplantation the patient was hospitalized due to fever of unknown origin. All microbiological samples were negative, but abdominal ultrasound revealed round solid mass in the right native kidney. Right nephrectomy was performed showing tumor 35 x 35 x 20 mm in size within the 70 x 40 x 35 mm kidney. Pathohistological analysis confirmed very rare monomorphic B-cell PTLD - B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma. Conclusion. We consider this case of PTLD following kidney transplantation particular because of the tumor mass in native kidney after basiliximab induction and rare pathohistology. In a transplanted patient with fever, PTLD must always be considered, irrespective of immunosuppressive regimen.

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