A French Cohort Study of Kidney Retransplantation after Post-Transplant Lymphoproliferative Disorders
Copyright © 2017 by the American Society of Nephrology..
BACKGROUND AND OBJECTIVES: Post-transplant lymphoproliferative disorders arising after kidney transplantation portend an increased risk of morbidity and mortality. Retransplantation of patients who had developed post-transplant lymphoproliferative disorder remains questionable owing to the potential risks of recurrence when immunosuppression is reintroduced. Here, we investigated the feasibility of kidney retransplantation after the development of post-transplant lymphoproliferative disorder.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We reviewed the data from all patients who underwent kidney retransplantation after post-transplant lymphoproliferative disorder in all adult kidney transplantation centers in France between 1998 and 2015.
RESULTS: We identified a total of 52 patients with kidney transplants who underwent 55 retransplantations after post-transplant lymphoproliferative disorder. The delay from post-transplant lymphoproliferative disorder to retransplantation was 100±44 months (28-224); 98% of patients were Epstein-Barr virus seropositive at the time of retransplantation. Induction therapy for retransplantation was used in 48 patients (i.e., 17 [31%] patients received thymoglobulin, and 31 [57%] patients received IL-2 receptor antagonists). Six patients were also treated with rituximab, and 53% of the patients received an antiviral drug. The association of calcineurin inhibitors, mycophenolate mofetil, and steroids was the most common maintenance immunosuppression regimen. Nine patients were switched from a calcineurin inhibitor to a mammalian target of rapamycin inhibitor. One patient developed post-transplant lymphoproliferative disorder recurrence at 24 months after retransplantation, whereas post-transplant lymphoproliferative disorder did not recur in 51 patients.
CONCLUSIONS: The recurrence of post-transplant lymphoproliferative disorder among patients who underwent retransplantation in France is a rare event.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
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| Enthalten in: |
Clinical journal of the American Society of Nephrology : CJASN - 12(2017), 10 vom: 06. Okt., Seite 1663-1670 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Caillard, Sophie [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 11.06.2018 Date Revised 13.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.2215/CJN.03790417 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Caillard, Sophie |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A French Cohort Study of Kidney Retransplantation after Post-Transplant Lymphoproliferative Disorders |
| 264 | 1 | |c 2017 | |
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| 500 | |a Date Completed 11.06.2018 | ||
| 500 | |a Date Revised 13.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2017 by the American Society of Nephrology. | ||
| 520 | |a BACKGROUND AND OBJECTIVES: Post-transplant lymphoproliferative disorders arising after kidney transplantation portend an increased risk of morbidity and mortality. Retransplantation of patients who had developed post-transplant lymphoproliferative disorder remains questionable owing to the potential risks of recurrence when immunosuppression is reintroduced. Here, we investigated the feasibility of kidney retransplantation after the development of post-transplant lymphoproliferative disorder | ||
| 520 | |a DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We reviewed the data from all patients who underwent kidney retransplantation after post-transplant lymphoproliferative disorder in all adult kidney transplantation centers in France between 1998 and 2015 | ||
| 520 | |a RESULTS: We identified a total of 52 patients with kidney transplants who underwent 55 retransplantations after post-transplant lymphoproliferative disorder. The delay from post-transplant lymphoproliferative disorder to retransplantation was 100±44 months (28-224); 98% of patients were Epstein-Barr virus seropositive at the time of retransplantation. Induction therapy for retransplantation was used in 48 patients (i.e., 17 [31%] patients received thymoglobulin, and 31 [57%] patients received IL-2 receptor antagonists). Six patients were also treated with rituximab, and 53% of the patients received an antiviral drug. The association of calcineurin inhibitors, mycophenolate mofetil, and steroids was the most common maintenance immunosuppression regimen. Nine patients were switched from a calcineurin inhibitor to a mammalian target of rapamycin inhibitor. One patient developed post-transplant lymphoproliferative disorder recurrence at 24 months after retransplantation, whereas post-transplant lymphoproliferative disorder did not recur in 51 patients | ||
| 520 | |a CONCLUSIONS: The recurrence of post-transplant lymphoproliferative disorder among patients who underwent retransplantation in France is a rare event | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Adult | |
| 650 | 4 | |a Antilymphocyte Serum | |
| 650 | 4 | |a Antiviral Agents | |
| 650 | 4 | |a Calcineurin | |
| 650 | 4 | |a Calcineurin Inhibitors | |
| 650 | 4 | |a Cohort Studies | |
| 650 | 4 | |a Epstein-Barr Virus Infections | |
| 650 | 4 | |a France | |
| 650 | 4 | |a Herpesvirus 4, Human | |
| 650 | 4 | |a Humans | |
| 650 | 4 | |a Lymphoproliferative Disorders | |
| 650 | 4 | |a Mycophenolic Acid | |
| 650 | 4 | |a Neoplasm Recurrence, Local | |
| 650 | 4 | |a Receptors, Interleukin-2 | |
| 650 | 4 | |a Reoperation | |
| 650 | 4 | |a Rituximab | |
| 650 | 4 | |a immunosuppression | |
| 650 | 4 | |a kidney | |
| 650 | 4 | |a kidney transplantation | |
| 650 | 4 | |a thymoglobulin | |
| 650 | 7 | |a Immunosuppressive Agents |2 NLM | |
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