Although the term Post-transplant Lymphoproliferative Disease (PTLD) encompasses all lymphoproliferative disorders post transplant, it generally refers to extra-nodal B-cell lymphomas due to Ebstein-Barr virus (EBV) infection. PTLD is a B-cell disease caused by iatrogenic T-cell dysfunction: in people…
A 53-year-old Caucasian male presented with pulmonary embolism, and was found to have nephrotic syndrome. A kidney biopsy showed membranous nephropathy (MN). The disease progressed despite treatment and six years later, the patient underwent a pre-emptive living unrelated…
A young patient was recently transferred to our service for evaluation of acute renal failure that had developed many years following a liver transplant for PSC. She had presented to another institution with nausea, vomiting, fevers and a…
What are the most common type of cancers in kidney transplant recipients? The three most common cancers are: non-melanoma skin cancers, Kaposi’s sarcoma and non-Hodgkin lymphomas. Compared to the general population, the risk of squamous cell carcinoma is…
One of my transplant patients came to clinic last week excited about his trip to Tanzania. He had undergone kidney transplantation three years ago and has had an uneventful course. As a transplant nephrologist, you kind of become…
Eculizumab is a humanized monoclonal antibody that binds to and prevents activation of the C5 complement protein. As you may remember, this protein is critical to the formation of the membrane attack complex (MAC) in complement dependent immune…
Keeping the bone theme: A 50-year-old woman with ESRD secondary to PKD underwent a living related-kidney transplant one-month prior. At clinic visit, she was complaining of severe throbbing pain in her hands and feet. The pain was worse…
KDIGO (page S6 of PDF) and the UK renal association have recently published guidelines for the clinical care of kidney transplant recipients. Both of these documents suggest that recipients at ‘higher immunological risk’ should be considered for induction…
It’s been a long time since my last blog post, so I have decided to catch up by writing about two cases I saw in my transplant clinic. However, they have the same disease, a brother and sister…
Spare a thought today for Ronald Lee Herrick who died on Monday at age 79. In 1954, his identical twin brother, Richard, had end-stage kidney disease with little prospect of long-term survival. Dr Joseph Murray, a pioneering surgeon…
