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Adverse Occurrence type:
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.
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