Post-transplantation lymphoproliferative disorders in renal vs. simultaneous renal-pancreas allograft recipients: a survey and analysis of data from the literature

The epidemiology and other aspects of post-transplantation lymphoproliferative disorders (PTLD) are different in different transplant populations. In this study,we sought to determine the clinical,histopathological and various other features of PTLD in recipients of pancreas-renal allografts and to compare their data with renal-only transplant patients,based on the current available literature. We conducted a comprehensive search for the available data using the Pubmed and Google scholar search engines for reports of lymphoproliferative disorders after renal and simultaneous pancreas-renal (SPR) transplantations. A total of 229 recipients of renal and pancreas-renal allografts were included in the analysis. Localizations for SPR recipients were significantly higher than renal recipients in the pancreas (P 0.0001),skin (P = 0.035),liver (P = 0.043) and bone marrow (P = 0.022). Involvement of lymph nodes was more prevalent in renal recipients (P = 0.046). The occurrence of metastasis was more common among SPR recipients (P = 0.005). Hodgkin s and Hodgkin s-like PTLD were also more prevalent among SPR transplant patients (P 0.0001). Time to development of PTLD was significantly shorter among recipients of SPR (P 0.0001). In this study of international data,we found that PTLD in SPR transplant recipients have various characteristics in their site of involvement,disease presentation time and histopathological features. However,no difference in outcome was detected in these groups of PTLD patients. Future studies with larger study populations are needed for confirming and extending our study results.