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- W4242810765 abstract "847 Between 3/27/89 and 12/31/97, 1316 kidney transplantations alone were performed under tacrolimus-based immunosuppression at our center. Post-transplant lymphoproliferative disorders (PTLD) developed in 25(1.9%) cases; the incidence in adults was 1.2%(15/1217), while in pediatric patients it was 10.1%(10/99; p<.0001). PTLD was diagnosed 21.0±22.5 months after transplantation, 25.0±24.7 months in adults, and 14.4±18.2 months in pediatric patients. Of the 4 adult cases in whom both the donor and recipient EBV serologies were known, 2 (50%) were + → −. Of 7 pediatric cases in whom both the donor and recipient EBV serologies were known, 6 (86%) were EBV + → −. Acute rejection was observed prior to the diagnosis of PTLD in 8/15 (53%) adults and 3/10 (30%) pediatric patients. Initial treatment of PTLD included a marked decrease or cessation of immunosuppression with concomitant ganciclovir therapy; 2 adults and 2 pediatric patients required chemotherapy. With a mean follow-up of 24.9±30.1 months after transplantation, the 1 and 5 year actuarial patient and graft survival rates in adults were 93% and 86%, and 80% and 60%, respectively. 2 adults died, 3.7 and 46.2 months after transplantation, of complications related to PTLD, and 7 lost their allograft 3.7-78.2 months after transplantation. In children, the 1 and 5 year actuarial patient and graft survival rates were 100% and 100%, and 100% and 89%, respectively. No child died; 1 child lost his allograft 41.3 months after transplantation. 1 child had presumed recurrent PTLD that responded to discontinuation of tacrolimus and re-initiation of antiviral therapy. The mean serum creatinine in adults was 2.3±1.2 mg/dl, and in children, it was 1.3±0.6 mg/dl. Under tacrolimus-based immunosuppression, PTLD is less common after renal transplantation in adults than in children, but PTLD in children is associated with more favorable outcomes than in adults." @default.
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- W4242810765 date "1999-04-01" @default.
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- W4242810765 title "POST-TRANSPLANT LYMPHOPROLIFERATIVE DISORDERS (PTLD) IN ADULT AND PEDIATRIC RENAL TRANSPLANT PATIENTS RECEIVING TACROLIMUS-BASED IMMUNOSUPPRESSION" @default.
- W4242810765 doi "https://doi.org/10.1097/00007890-199904150-00871" @default.
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