| Autor: |
Diogo Francisco, Lúcio Requião-Moura, Rui Nogueira, Rodrigo Nóbrega Alencar, Renato Demarchi Foresto, Helio Tedesco-Silva, José Medina Pestana |
| Jazyk: |
English<br />Portuguese |
| Rok vydání: |
2024 |
| Předmět: |
|
| Zdroj: |
Brazilian Journal of Nephrology, Vol 46, Iss 4 (2024) |
| Druh dokumentu: |
article |
| ISSN: |
2175-8239 |
| DOI: |
10.1590/2175-8239-jbn-2024-0040en |
| Popis: |
Abstract Introduction: This study investigated variables associated with mortality in kidney transplant recipients (KTRs) diagnosed with post-transplant lymphoproliferative disease (PTLD) and a simultaneous Epstein-Barr virus (EBV) viremia. Methods: This was a retrospective cohort study enrolling KTRs diagnosed with PTLD between 2018 and 2020. Outcome: death within two years after diagnosis. Results: Among 1,625 KTRs who collected EBV viremia (by PCR, 2018–2020) for any reason, 238 (14.6%) had a positive viral load and 41 (17.2%) simultaneous PTLD. These 41 patients were 40.1 years old at diagnosis and 8.6 years after transplantation; 26.8% were induced with rATG and 92.7% were maintained on tacrolimus and azathioprine (TAC/AZA) as immunosuppressive regimen. Lymph nodes (75.6%) was the most common site of PTLD, followed by the gastrointestinal tract (48.8%), with 61.0% at Lugano stage IV and 80.5% monomorphic PTLD. The mean EBV viral load was 12,198 IU/mL. One- and two-year patient survival post-diagnosis was 60.4% and 46.8%, respectively. In the Cox regression analysis, age at PTLD diagnosis (HR for each year = 1.039; p < 0.001) and EBV viral load (HR for each log = 1.695; p = 0.026) were associated with risk of death. Conclusion: This study suggests that in patients predominantly on TAC/AZA, PTLD with simultaneous EBV positive viral load is a late event, and worse survival is associated with older age and EBV viral load at diagnosis. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
|
