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Background: The adenotonsillar region is an important localization for post-transplantation lymphoproliferative disorders (PTLD) due to its anatomical relevance. In this study, we sought to aggregate data of PTLD series reported by different international authors on tonsillar and adenoidal localization of PTLD and to compare their data with other PTLD patients., Material/methods: We conducted a comprehensive search for the available data by Pubmed and Google Scholar search engines for reports of lymphoproliferative disorders occurring within tonsils and adenoids among organ transplant patients. Data from 22 previously published studies from various countries were included into analysis., Results: Overall, 352 patients with lymphoproliferative disorders after organ transplantation were entered into analysis. Patients with adenotonsillar PTLD were significantly younger (13 ± 15 vs. 26 ± 23 yr/o; p < 0.0001), more frequently females (56% vs. 35%; p = 0.013), less likely to develop metastasis (4.5% vs. 12.5%; p = 0.07), and were more frequently from polyclonal (80% vs. 53%; p = 0.002) and polymorphic (68% vs. 27%; p=0.001) histopathologic features. Adenotonsillar PTLD also had a significantly superior survival than other PTLD localizations during the first 4 year after diagnosis (p = 0.031). Five-year survival rates for adenotonsillar PTLD and other PTLD localizations were 54% and 39%, respectively., Conclusions: We found that adenotonsillar localization by PTLD is a relatively benign disease with respect to its histological features and survival compared to other sites of PTLD involvement. Adenotonsillar PTLD is more prevalent in younger patients, females and liver transplant recipients. Therefore, to enhance early detection and treatment, we seek to alert doctors about any adenotonsillar symptoms in pediatric transplant recipients.

Background: Post-transplant lymphoproliferative disorders (PTLDs) can occur within the allograft, representing a differential diagnosis for an acute rejection episode; in this study, we collected data from PTLD patients involving kidney allografts, and compared their characteristics with other renal transplant patients from the same centers who developed PTLDs localized elsewhere., Material/methods: A comprehensive search was made by Pubmed and Google Scholar for reports of lymphoproliferative disorders after renal transplantation. Data from 17 studies were included into analysis. Having at least 1 patient with renal allograft involvement by PTLD was inclusion criterion. Data for patients was collected by use of a standard questionnaire., Results: PTLD complicated renal allograft in 46 (37%) of our study population. Renal transplant recipients with allograft localization of PTLD had better survival than other PTLD patients unless they developed multi-organ involvement (p=0.007). Five-year survival rate was 73% for graft PTLD and 42% for other localizations. Graft PTLD patients had shorter time from transplant to PTLD (p=0.01) and were more likely to present as polyclonal and polymorph in their histological evaluations (p<0.05)., Conclusions: Renal transplant recipients who develop allograft dysfunction during the early post-transplantation period should get full evaluations for a potential PTLD development at their allograft site. Before development of multi-organ involvement allograft PTLD in renal transplant patients has a benign behavior; therefore it is crucial to evaluate renal recipients with initial symptoms of PTLDs.

Background: The impact of EBV infection on the incidence of post-transplant lymphoproliferative disorders (PTLDs) is well established, but scant data exists on the significance of such an infection on organ transplant recipients who develop lymphoproliferative disorders. In the present study, we investigated the epidemiology of EBV infection in renal transplant recipients developing post-transplant lymphoproliferative disorders and its potential impact on these patients., Material/methods: International data from 5 different studies were included in the analysis. Complete remission (CR) was defined as no evidence of disease by different diagnostic methods. Partial remission was defined as a substantial decrease in measurable known lesions without the appearance of new ones., Results: Overall 45 PTLD patients were included into analysis. Remission rate was significantly higher in EBV negative patients (p=0.010). Patients with EBV infection had significantly lower patient survival rate (p=0.06). Incidence of early onset PTLDs was significantly related to EBV infection (p=0.02)., Conclusions: This study demonstrates EBV infection is a major complication in post-transplant lymphoproliferative patients. Physicians should more intensively follow their EBV-infected transplant patients who have lymphoproliferative disorders.

Background: Organ transplantation increases the risk of cancer including lymphomas through various and insidious mechanisms. In this study, we aimed to gather and analyze data of 5 international studies on late onset lymphoproliferative disorders after renal and liver transplantation., Material/methods: We conducted a comprehensive search for the available data by Pubmed and Google scholar search engines on post transplant lymphoproliferative disorders. A standard questionnaire was developed to collect data from different published studies. Finally, trustable data of a total of 5 publishes were included in the final analysis. We reviewed all their characteristics and various factors available which may affect outcome. We also compared outcome of patients with very late onset PTLD (>10 years) and late PTLDs. For data analysis we used SPSS v. 13.0. Kaplan-Meier Method was used for survival analysis and Students' t test and chi2 tests were used where appropriate. P<0.05 was defined as significant., Results: overall 55 cases of PTLD from 5 international reports were entered into analysis. There were 32 (58%) males and 23 (42%) female patients. Mean age at diagnosis of PTLD was 39+/-12 years. The mean interval between transplantation and the diagnosis of PTLD was 86+/-54 whereas follow up time after diagnosis of PTLD was 34+/-99 months. Exteranodal involvement was 65%. There were no significant differences in outcomes of patients with late and very late onset PTLDs. Despite discontinuation or reduction of immunosuppressive agents, surgical therapy, chemotherapy, and radiotherapy, 55% of the patients died., Conclusion: Late onset PTLD has its highest relevance within the first year after diagnosis. Controlling infections in PTLD patients during this time period could have beneficial effects on patients' survival. Long post-transplant latency period, aggressive behavior and poor response to treatment necessitate early diagnosis and treatment of late onset post-transplant lymphomas in kidney transplant recipients.

Background: Post-transplant lymphoproliferative disease (PTLD) is a major complication after solid organ transplantation and most frequently occurs during the first year post transplantation. We analyzed patient characteristics, outcome and prognostic factors for survival of transplant patients who developed post transplant lymphoproliferative disorders within one year after transplantation reported by 5 major studies worldwide., Material/methods: We made a comprehensive search for the available data by Pubmed and Google scholar search engines on post transplant lymphoproliferative disorders. A standard questionnaire was developed to collect data from different published studies. Finally, trustable data of a total of 5 publishes were included in the final analysis. For data analysis we used SPSS v. 13.0. Kaplan-Meier Method was used for survival analysis. P<0.05 was defined as significant., Results: Data of 16 patients who developed PTLD during the early 12 months after transplantation (2 liver and 14 renal) were recruited from 5 studies and entered into analysis. Mean age was 41.9+/-16.2 years. Univariate survival analysis showed that localization of the PTLD in brain in PTLD patients induces a highly significant adverse effect on the outcome of PTLD patients (P=0.008) but not for other localizations. We aso found that involvement of the allograft (all kidney allograft) is associated with higher rate of remission (either partial or complete remission) of PTLDs after anti-cancer therapy. No associations were found regarding other variables., Conclusions: Because of the higher incidence rate and fatal nature, early onset PTLD is of extreme relevance. Screening all renal transplant patients in the early post transplantation period for an early detection and treatment of PTLDs is crucial, particularly in patients who are more likely to develop PTLDs.

The first child born to a renal transplant patient who was the first woman undergone a renal transplant from her identical twin celebrated his 53th birthday on March 10, 2009. Since this first experience, over 14,000 births among women with transplanted organs have been reported worldwide and several more also not reported. Pregnancy is now considered a frequent part of women after organ transplantation. However, substantial gaps remain in our knowledge about pregnancy in the transplant recipient and its effects on the mother and child. As well, several ethical concerns have been raised about the wisdom of pregnancy for a woman with a proportionally lower life span with expected medical complications. In this review article we tried to address all issues related to pregnancy after renal transplantation.,