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Urothelial carcinoma of donor origin in a kidney transplant patient

Overview of attention for article published in Journal for Immunotherapy of Cancer, October 2016
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Title
Urothelial carcinoma of donor origin in a kidney transplant patient
Published in
Journal for Immunotherapy of Cancer, October 2016
DOI 10.1186/s40425-016-0167-4
Pubmed ID
Authors

Rosa M. Michel Ortega, Daynna J. Wolff, Cynthia A. Schandl, Harry A. Drabkin

Abstract

Malignancy after transplantation is an uncommon multifactorial occurrence. Immunosuppression to prevent graft rejection is described as a major risk factor in malignancy development in the post-transplant state. Donor-derived malignancy is a rare reported complication. Herein, we review our patient history and discuss diagnostic strategies and the implications of immunosuppression for donor-derived malignancy. This is a 69-year-old man with post-renal-transplant urothelial carcinoma determined to be of donor origin. His course was complicated by BK virus at six years post-transplant; urothelial carcinoma was identified nine years post-transplant. Cystectomy was performed, but because of immunosuppression and underlying chronic kidney disease, the patient was considered ineligible for adjuvant chemotherapy. Two years after resection, screening MRI demonstrated retroperitoneal lymphadenopathy and a right upper pole mass in the transplanted kidney. Urine cytology confirmed the presence of malignant cells; FISH showed 2-8 copies of the X chromosome and no Y chromosome consistent with female origin of the malignant cells. CT-guided renal mass and paraaortic lymph node biopsies demonstrated that about 50 % of cells had an XY complement, while the remainder showed a XX genotype by chromosomal SNP microarray analysis. Immunosuppression was discontinued and the donor kidney removed. X/Y FISH of the urothelial carcinoma identified in the explanted kidney confirmed that the malignant cells were of female donor origin. Follow-up at 3, 6 and 12 months after discontinuation of immunosuppression and surgery demonstrated normalization of the lymphadenopathy and absence of new lesions. Immunosuppression is a major risk factor for development of malignancy in transplant recipients. Donor-derived malignancy can arise and current molecular studies allow an accurate diagnosis. Withdrawal of immunosuppression and surgical resection of the transplant kidney proved an effective treatment in our case.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 31 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 31 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 4 13%
Student > Ph. D. Student 3 10%
Researcher 3 10%
Student > Postgraduate 3 10%
Student > Doctoral Student 2 6%
Other 7 23%
Unknown 9 29%
Readers by discipline Count As %
Medicine and Dentistry 14 45%
Pharmacology, Toxicology and Pharmaceutical Science 1 3%
Agricultural and Biological Sciences 1 3%
Biochemistry, Genetics and Molecular Biology 1 3%
Psychology 1 3%
Other 1 3%
Unknown 12 39%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 November 2016.
All research outputs
#17,285,668
of 25,373,627 outputs
Outputs from Journal for Immunotherapy of Cancer
#2,887
of 3,421 outputs
Outputs of similar age
#209,637
of 324,018 outputs
Outputs of similar age from Journal for Immunotherapy of Cancer
#27
of 28 outputs
Altmetric has tracked 25,373,627 research outputs across all sources so far. This one is in the 21st percentile – i.e., 21% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,421 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 15.4. This one is in the 11th percentile – i.e., 11% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 324,018 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 27th percentile – i.e., 27% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 28 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.