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Patient and Renal Outcomes of Post Transplant Lymphoproliferative Disorder Following Solid Organ Transplantations – A Single Center Experience

G. Katz-Greenberg1, K. Mallari2, U. Martinez-Outschoorn1, M. P. MartinezCantarin1

1Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, 2Thomas Jefferson University, Philadelphia, PA

Meeting: 2020 American Transplant Congress

Abstract number: D-186

Keywords: Immunosuppression, Malignancy

Session Information

Session Name: Poster Session D: PTLD/Malignancies: All Topics

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Posttransplant lymphoproliferative disorder (PTLD) remains an unfortunate complication in patients following solid organ transplantation (SOT) and hematopoietic stem cells transplantations. The diagnosis of PTLD is made based to the World Health Organization (WHO) histopathological 2017 classification. Epstein-Barr virus (EBV) contributes to the pathogenesis of PTLD in more than 70% of cases. Prior to 2000, the reported 5-year patient survival rate after PTLD diagnosis was around 40%. More recent observational studies show increased incidence of PTLD in the past two decades, but also an improved 5-year survival to around 50%. The increased incidence is thought to be related to increased numbers of SOT, an older age of donors and recipients, use of newer immunosuppressive agents, and improved diagnostic tools. The aim of our study was to examine patient and renal outcomes following SOT in our center.

*Methods: We retrospectively reviewed the electronic medical records of all patients who had a SOT followed by the diagnosis of PTLD. We extracted basic donor and recipient characteristics, time interval between SOT and PTLD diagnosis, disease characteristics, response to treatment, and outcomes.

*Results: In our center, there were 32 patients that underwent a SOT and were later diagnosed with PTLD. Of them, 12 were female, and 8 were non-Hispanic blacks. PTLD was diagnosed in 18 kidney transplants, 11 liver transplants, 2 simultaneous kidney-pancreas transplants, and one simultaneous liver-kidney transplant. Mean time from SOT to PTLD diagnosis was 63 months, with 13 patients diagnosed in the 1st year post transplant. The main PTLD subtype was monomorphic B-cell lymphoma (20/32 patients) and 16 of them were diffuse large B cell lymphomas (DLBCL). Three patients had graft involvement by PTLD. Mean serum creatinine was 2.29 mg/dL, with mean follow up time of 57.7 months. There were 11 deaths in the cohort (33%), and 5 graft failures (15%) at the five year follow up mark.

*Conclusions: In our cohort, with approximately 5 years of follow up, mortality was 33%, better than the 50% reported from the literature. The majority of the PTLD patients were diagnosed with monomorphic, B-cell lymphoma, DLBCL subtype. PTLD diagnosis was also not associated with significant graft loss at 5 years. Further studies are needed to look at the disease characteristics that will help determine more specific prognostic factors.

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To cite this abstract in AMA style:

Katz-Greenberg G, Mallari K, Martinez-Outschoorn U, MartinezCantarin MP. Patient and Renal Outcomes of Post Transplant Lymphoproliferative Disorder Following Solid Organ Transplantations – A Single Center Experience [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/patient-and-renal-outcomes-of-post-transplant-lymphoproliferative-disorder-following-solid-organ-transplantations-a-single-center-experience/. Accessed May 11, 2025.

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