Characteristics and prognosis of lymphoproliferative disorders post-renal transplantation in living versus deceased donor allograft recipients

• Published in: Saudi journal of kidney diseases and transplantation 2013-09, Vol.24 (5), p.903-909
• Main Authors: Khidmat, Husayn, Tahiri, Said
• Format: Article
• Language: English
• Subjects: Adult; Diagnosis; Diseases; Female; Humans; Kidney Transplantation - adverse effects; Kidney Transplantation - methods; Kidney Transplantation - mortality; Kidneys; Living Donors; Lymphatics; Lymphoproliferative disorders; Lymphoproliferative Disorders - etiology; Lymphoproliferative Disorders - mortality; Male; Medical examination; Middle Aged; Neoplasm Metastasis; Organ transplant recipients; Prognosis; Retrospective Studies; Risk factors; Transplantation; Transplantation, Homologous; الأمراض; الاضطرابات التكاثرية اللمفية; التشخيص; الكلى; زرع الأعضاء; مآلات المرض
• ISSN: 1319-2442; 2320-3838
• DOI: 10.4103/1319-2442.118069

In this study, we compared the features and prognosis of post-transplantation lymphoproliferative disorders (PTLD) occurring in living donor recipients with those of deceased donor kidney transplant patients. A comprehensive search was performed for finding studies reporting data of PTLD in living and deceased donor renal recipients in the Pubmed and Google scholar search engines. Finally, international data from 14 different studies were included in the analysis. Overall, 122 renal recipients with PTLD were entered into this analysis. Chi square test showed that renal recipients from living donors significantly less frequently represented any remission episodes during the course of their disease (41% vs. 63%, respectively; P = 0.05). Living donor renal recipients were significantly more likely to develop metastasis in comparison with deceased donor recipients (64% vs. 23%, respectively; P = 0.035). Histopathological evaluations were comparable between the two patient groups. Survival analysis did not show any difference between the patient groups, even when patients were adjusted for the type of immunosuppression. The mortality rate of the transplant patients with PTLD was 55.3% and the 1- and 5- year patients survival rates were 50% and 37%, respectively, for the deceased donor renal recipients compared with 60% and 34%, respectively, for the living donors group. We conclude that living donor kidney transplant recipients who develop PTLD have a higher rate of metastasis and a lower rate of remission episodes. Further prospective studies with a large patient population are needed to confirm our results.