outcome of rapamycin therapy for post-transplant-lymphoproliferative disorder after kidney transplantation: case series.

background: post-transplant lymphoproliferative disorders (ptld) are a complication of chronic immunosuppressive therapy in solid organ transplantation with a high mortality rate. alternative treatments such as rapamycin have been explored. methods: a detailed retrospective analysis was performed according to data collected from 13 patients with ptld. at the time of ptld diagnosis, immunosuppressive therapy was decreased and rapamycin administered. overall survival, disease-free survival of patients and graft survival were determined. results: among 590 kidney transplant recipients, 13 adult patients with ptld were included in this study. the mean age of the patients was 42.15 (range: 25-58) years at the time of ptld diagnosis, and 9 patients were male. histology was distributed in 9 diffuse large b cell, 1 malt lymphoma, 1 burkitt lymphoma, 2 hodgkin-like ptld. the response rate to rapamycin alone was 30.8%. the mean overall survival period was 23.38 months and 11 patients are still alive. in total, 10 patients (76.9%) achieved a complete remission with functioning graft in 11 (84.6%) patients. conclusion: despite the retrospective focus and limited number of patients, this study provides promising results regarding the effectiveness of stopping calcineurin inhibitors and switching to rapamycin for patients with ptld.