Epstein-Barr virus lymphoproliferative disease of donor origin after kidney transplantation: A case report

Post-transplant lymphoproliferative disease (PTLD) is a serious complication after organ transplantation. We describe the case of a 45-year old patient who developed an EBV associated B-cell lymphoma in a cadaveric renal allograft. This case underscores the importance of considering PTLD as possible differential diagnosis for allograft dysfunction. Careful diagnostic evaluation should be undertaken in patients who present with risk factors for development of PTLD such as high doses of immunosuppression for rejection therapy, suspicious EBV serologies or negative EBV serologies before transplantation. PTLD can be of donor or recipient origin. Independent of its origin PTLD needs an immediate therapy which depends on the histology of the lymphoma and on the clinical conditions of the patient. Therapeutic options are reduction of the immunosuppression, chemotherapy or radiation, administration of lymphocyte-specific antibodies or removal of the kidney allograft.

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“…2). Allerdings gibt es beschriebene Fälle von PTLD nach Nierentransplantation,bei denen die lymphatischen Zellen vom Spender stammen [14].…”

Section: Renale Lymphomeunclassified

Dysfunktion einer Transplantatniere mit bedrohlichem Befund

et al. 2004

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“…We previously described a case of EBV-associated B-cell lymphoma presenting as extrinsic compression of the allograft artery that produced an exacerbation of hypertension [10]. Most of the patients developed PTLD within 1 year after transplantation [26].…”

Section: Clinical Featuresmentioning

confidence: 99%

“…The clinical presentation is variable, including fulminant forms. Fever is a common sign in diffuse PTLD [26].…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Our experience as well as a review of the literature suggests that the discontinuation of immunosuppression and transplant removal are advisable in patients with involvement restricted to the renal allograft [10,26]. In some cases presenting with a very limited extension, the reduction or withdrawal of immunosuppression may lead to complete resolution of the disease without other treatment [14].…”

Section: Treatment and Progressmentioning

confidence: 99%

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Lymphoproliferative disorders after renal transplantation: role of medical imaging

et al. 1998

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Post-transplantation lymphoproliferative disorders (PTLD) are a complication of immunosuppressed transplant recipients, and their incidence is reported to be 20-120 times greater than the rate in the general population. After kidney transplantation, PTLD more likely arise within the renal transplant fossa. Radiological patterns of these forms are presented and discussed, according to a review of the literature, and illustrated by cases from our institution. Ultrasound plays an essential role in the early diagnosis of PTLD by detecting a urinary obstruction associated with adenopathy or an ill-defined mass not previously seen. However, in the case of an inconclusive US examination, CT or MRI should be performed to confirm the presence of a mass. Both techniques are useful in evaluating the extension of the process within the transplantation fossa; MRI seems more accurate and can be used for the follow-up, especially after reduction in immunosuppressive therapy without transplant removal.

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“…These tumors are most commonly of B cell origin and are associated with Epstein-Barr virus (EBV) infection [2][3][4]. Their incidence varies, depending on the types of organs transplanted, the degree and duration of immunosuppression, EBV infection, and chronic antigenic stimulation [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Early Posttransplant Lymphoproliferative Disorder Presenting with Ureteric Obstruction in En Bloc Kidneys

et al. 2000

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We describe a female patient who received double pediatric (en bloc) kidney transplants. She presented initially with fever of unknown origin 3 months after transplantation; 5 months after surgery, she presented with obstruction of one ureter followed by obstruction of the other. After 9 months she developed posttransplant lymphoproliferative disorder in both kidneys. To our knowledge, this is the first case report of this disorder occurring in en bloc kidneys and presenting with bilateral ureteric obstruction.

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Epstein-Barr virus lymphoproliferative disease of donor origin after kidney transplantation: A case report

Cited by 24 publications

References 12 publications

Dysfunktion einer Transplantatniere mit bedrohlichem Befund

Dysfunktion einer Transplantatniere mit bedrohlichem Befund

Lymphoproliferative disorders after renal transplantation: role of medical imaging

Early Posttransplant Lymphoproliferative Disorder Presenting with Ureteric Obstruction in En Bloc Kidneys

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