A French Cohort Study of Kidney Retransplantation after Post-Transplant Lymphoproliferative Disorders

被引：28

作者：

Caillard, Sophie ^{[1
]}

Cellot, Etienne ^{[1
]}

Dantal, Jacques ^{[1
]}

Thaunat, Olivier ^{[1
]}

Provot, Francois ^{[1
]}

Janbon, Benedicte ^{[1
]}

Buchler, Matthias ^{[1
]}

Anglicheau, Dany ^{[1
]}

Merville, Pierre ^{[1
]}

Lang, Philippe ^{[1
]}

Frimat, Luc ^{[1
]}

Colosio, Charlotte ^{[1
]}

Alamartine, Eric ^{[1
]}

Kamar, Nassim ^{[1
]}

Heng, Anne Elisabeth ^{[1
]}

Durrbach, Antoine ^{[1
]}

Moal, Valerie ^{[1
]}

Rivalan, Joseph ^{[1
]}

Etienne, Isabelle ^{[1
]}

Peraldi, Marie Noelle ^{[1
]}

Moreau, Anne ^{[1
]}

Moulin, Bruno ^{[1
]}

机构：

[1] Serv Nephrol, 1 Pl Hop, F-67091 Strasbourg, France

来源：

CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2017年 / 12卷 / 10期

关键词：

ORGAN TRANSPLANT RECIPIENTS; TERM-FOLLOW-UP; RENAL-TRANSPLANTATION; INITIAL THERAPY; UNITED-STATES; ADULT KIDNEY; IMMUNOSUPPRESSION; REGISTRY; RISK; PTLD;

D O I：

10.2215/CJN.03790417

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：1663 / 1670

页数：8

共 28 条

[1] Long-term follow-up of kidney transplant patients with posttransplant lymphoproliferative disorder: Duration of posttransplant lymphoproliferative disorder-induced operational graft tolerance, interleukin-18 course, and results of retransplantation [J].