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Research Mentor Name

Dr. Anita Patel

Research Mentor Email Address

apatel2@hfhs.org

Institution / Department

Henry Ford Hospital, Transplant Institute

Document Type

Research Abstract

Research Type

clinicalresearch

Level of Research

no

Abstract

Introduction:

Post-transplant lymphoproliferative disorder (PTLD) is a serious complication occurring in 1-3% of adult renal transplant recipients (RTR). We present a case series of 16 RTR who demonstrate a variety of PTLD manifestations.

Results:

63% of RTR received rATG induction and 38% Basiliximab. Maintenance immunosuppression post-transplantation was Prednisone, Tacrolimus, and Mycophenolate Mofetil.

Average time from transplantation to PTLD diagnosis was 96.8 months (

Immunosuppression was discontinued in all RTR at diagnosis except Prednisone. Treatment was chemotherapy alone or in combination with radiation, resection, or salvage therapy; complications included Tumor Lysis Syndrome and infections. 56% of RTR developed renal insufficiency.

5 RTR (31%) achieved complete remission with a functioning graft. PTLD mortality rate was 63%; 9 RTR died with a functioning graft. Mortality with Basiliximab induction was 83% and 55% with rATG induction. T-cell PTLD had a 100% mortality while B-cell PTLD had a 54% mortality. EBV- PTLD had a higher mortality rate (88%) than EBV + (38%) PTLD. Patients died between

Conclusion:

PTLD with T-cell characterization, EBV negative status, and bone marrow and lymph node involvement demonstrated an increased mortality rate. PTLD has a myriad of manifestations and should be considered as a differential diagnosis in patients presenting with post-transplant lesions.

Disciplines

Medicine and Health Sciences

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