Case report: Diffuse large B-cell lymphoma (intravascular) after kidney transplant (2014)

Status: 
Ready to upload
Record number: 
1572
MPHO Type: 
Estimated frequency: 
Most recent risk assessment for leukemia, lymphoma and plasmacytoma (Council of Europe, 2022): Leukaemia, lymphoma and plasmacytoma diagnosed during donor procurement: These cancers are classified as an unacceptable risk for organ donation. Leukaemia, lymphoma and plasmacytoma in the donor history: Active (acute or chronic) leukaemia, lymphoma and plasmacytoma are an unacceptable risk for organ donation. Treated acute leukaemia and lymphoma after a definite disease-free interval of 10 years may be considered for organ donation with an assumed high risk for transmission.
Time to detection: 
1 - 2 months
Alerting signals, symptoms, evidence of occurrence: 
Delayed recovery of graft function in kidney recipient number 1, adequate graft function for kidney recipient number 2. Protocol 30 day kidney biopsy and histological examination disclosed diffuse large B-cell lymphoma of the intravascular type, transplant nephrectomy performed in both cases.
Demonstration of imputability or root cause: 
Multiorgan donor with suspected encephalomeningitis. Rapid deterioration prevented planned brain biopsy. Both kidneys and liver transplanted. Protocol 30 day renal biopsy detected intravascular B cell lymphoma. Other centers notified, tumor also found in second renal recipient, no tumor found in liver recipient. No specific symptoms in any patient; one renal recipient had delayed graft function, one had aneurysm of graft anastomosis corrected. Both kidney patients underwent allograft nephrectomy and received chemotherapy. Despite this, one died, the other survived. Liver recipient also received prophylactic chemotherapy and survived. Follow up time calculated from time of transplant to publication is 4 years and 4 months.
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
Suggest references: 
Dziewanowski K1, Drozd R, Parczewski M, Klinke M. et al. (2014). Multiorgan transplantation from a deceased donor with intravascular diffuse large B-cell lymphoma: transmission of the disease and results of treatment. Clin Transplant. 28(10):1080-3