Vázquez LJ, Bezaury RP, Alberú J

Language: Spanish
References: 10
Page: 193-198
PDF size: 153.87 Kb.

ABSTRACT

Introduction. Renal transplant is the replacement treatment of choice, in patients with terminal chronic renal insufficiency, since it increases survival and in most of cases the patients’ quality of life, when compared to hemodyalisis. The significant development and evolution of surgical techniques, as well as new immunosuppressants such as: cyclosporine, OKT3 and FK506, are the main causes of patients survival increase. However, unfortunately, one of the more serious complications for this type of patients is the Post-Transplant Lymphoproliferative Disease (PLTD).
Purpose: To show usefulness and importance of different imaging methods for an appropriate diagnosis of PTLD.
Material and methods: A description of PTLD findings with primary affection to grafts in patients with renal transplant for the different diagnosis methods is made, as well as the literature review.
Results: This condition is given as chronic immunosuppression after effects; and it is believed that the virus Epstein Barr induces this disease for most of the patients. Approximately, 1% of patients with renal transplant may show this complication and most of the time the results is fatal.
Conclusion: Clinic manifestations of PTLD are non specific or silent, most of the times are detected when the patient is studied for other reasons. Consequently, it is important the radiologist is familiar with findings for imaging of different manifestations of this disease in order to have an opportune diagnosis and to begin the appropriate treatment.

REFERENCES

1. Vrachliotis TG, Vaswani KK, et al. CT Findings in posttransplantation lymphoproliferative disorder of renal transplants. AJR 2000; 175: 183-8.

2. Jain A, Mazariegos G, Kashyap R, et al. Comparative long-term evaluation of tacrolimus and cyclosporine in pediatric liver transplantation. Transplantation 2000; 70(4): 617-25.

3. Ciancio G, Siquijor AP, Burke GW, et al. Post-transplant lymphoproliferative disease in kidney transplant patients in the new immunosuppressive era. Clin Transplant 1997; 11(3): 243-9[Medline].

4. Cockfield SM, Prieksaitis JK, Jewell LD, Parfrey NA. Post-transplant lymphoproliferative disorder in renal allograft recipients. Transplantation 1993; 56: 88-96.

5. Dodd GD III, Greenler DP, Confer SR. Thoracic and abdominal manifestations of lymphoma occurring in the immunocompromised patient. Radiol Clin North Am 1992; 30: 597-610.

6. Hanto DW, Gajl-Peczlaska KJ, Frizzera G, et al. Epstein-Barr virus (EBV) induced polyclonal and monoclonal B-cell lymphoproliferative diseases occurring after renal transplantation. Ann Surg 1983; 198: 365-9.

7. Lopez-Ben, Smith JK, Kew CE II, Kenney PJ, Julian BA, Robbin ML. Focal posttransplantation lymphoproliferative. Disorder at the renal allograft hilum. AJR 2000; 175: 1417-22. AJR 2000; 175: 183-8.

8. Claudon M, Kessler M, Champigneulle J, Lefevre F, Hestin D, Renoult E. Lymphoproliferative disorders after renal transplantation: Role of medical imaging. Eur Radiol 1998; 8: 1686-93.

9. Ali MG, Coakley FV, Hricak H, Bretan PN. Complex posttransplantation abnormalities of renal allografts: Evaluation with MR imaging. Radiology 1999; 211: 95-100.

10. Vrachliotis TG, Vaswani KK, Davies EA, et al. CT findings in posttransplantation lymphoproliferative disorder of renal transplants. AJR 2000; 175: 183-8.