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Adverse Occurrence type:
Time to detection:
Alerting signals, symptoms, evidence of occurrence:
Liver recipient with no symptoms but biopsied upon information regarding kidney lymphoma. Delayed recovery of graft function in kidney recipient number 1, adequate graft function for kidney recipient number 2. Protocol (1 month) 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 cadaveric donor retrieval of two kidneys and a liver. Similar histological features of intravascular B cell lymphoma found in both kidney recipients and the postmortem examination of the donor. No malignancy was observed in the liver transplant recipient who underwent liver and bone marrow biopsies and PET scan, who nevertheless received prophylactic chemotherapy. This led to liver enzyme elevation related to hepatitis C virus reactivation, but resolved.
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. doi: 10.1111/ctr.12417