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Analysis of diagnosis and treatment of lymphoproliferative diseases after kidney transplantation

Hao Changzhen;Gao Zihao;Sun Zejia;Wang Wei;Department of Urology, Beijing Chaoyang Hospital, Capital Medical University;  
Objective Through the diagnosis and treatment process of 3 patients with post-transplant lymphoproliferative disorders(PTLD), the etiology, clinical manifestations and diagnosis and treatment measures of PTLD after kidney transplantation were discussed. Methods A retrospective analysis of 3 patients with PTLD diagnosed and treated in Beijing Chaoyang Hospital affiliated to Capital Medical University from 2010 to 2022 was performed. Results All patients had received three-drug-immunosuppression after transplantation, and the duration between renal transplantation and diagnosis of PTLD was 5 months, 6 months, and 120 months, respectively. All patients had symptoms of compression at the corresponding location caused by enlarged regional lymph nodes. Upon diagnosis,the dosage of immunosuppressive drugs was reduced, supplemented with rituximab or chemotherapy. Clinical complete remission was achieved in one case, and the lesion of the remaining patients was significantly reduced. Conclusion PTLD is one of the rare complications after kidney transplantation, with poor prognosis and heterogeneous clinical manifestations. Lymph node enlargement is one of the typical manifestations of this disease. Early imaging and histopathological examinations are ideal for a definite diagnosis and early adjustment.The combination of immunosuppressive dose adjustment,application of rituximab and chemotherapy as well as other measures can improve the prognosis and reduce the mortality of patients.
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