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Related Experiment Videos

Rapidly developing T-cell posttransplantation lymphoproliferative disorder.

J Y Kim1, C W Kim, C Ahn

  • 1Departments of Pathology and Internal Medicine, Seoul National University College of Medicine, Korea.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|July 13, 1999
PubMed
Summary

This report details a rare case of T-cell posttransplantation lymphoproliferative disorder (PTLD) in a kidney transplant recipient. Reducing immunosuppression led to PTLD regression but triggered graft rejection.

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Global Transplantation COVID Report March 2020.

Transplantation·2020

Area of Science:

  • Transplantation immunology
  • Onco-immunology
  • Nephrology

Background:

  • Posttransplantation lymphoproliferative disorder (PTLD) is a rare complication following organ transplantation.
  • PTLD of T-cell origin is exceptionally uncommon in chronically immunosuppressed allograft recipients.
  • Standard immunosuppressive regimens may contribute to the development of PTLD.

Observation:

  • A case of T-cell PTLD occurred in a renal allograft recipient shortly after transplantation under triple immunosuppression.
  • Renal graft biopsy revealed extensive infiltrates of T-cell lineage lymphoid cells (UCHL-1+, CD3+).
  • Polymerase chain reaction (PCR) confirmed clonal T-cell receptor gamma chain gene rearrangement.

Findings:

  • PCR and in situ hybridization excluded human T-cell leukemia virus type 1 (HTLV-1) and Epstein-Barr virus (EBV) as causative agents.

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  • Reduction of immunosuppressive therapy resulted in PTLD lesion regression.
  • Subsequent graft biopsy showed signs of rejection after immunosuppression reduction.

    • Implications:

    • This case highlights the rare occurrence of rapidly developing T-cell PTLD in renal allografts.
    • The findings underscore the complex interplay between immunosuppression, PTLD, and graft rejection.
    • Further research into T-cell PTLD pathogenesis and management in transplant recipients is warranted.