Late occurrence of malignant post‐transplant lymphoproliferative disorder (PTLD) presenting with severe acute renal failure

We report the case of a 63-year-old man who presented with severe acute renal failure requiring dialysis 17 years after a successful renal transplant of a kidney from his daughter. Transplant kidney biopsy revealed post-transplant lymphoproliferative disorder-large B-cell lymphoma. A PET scan revealed widespread disease, particularly involving the transplanted kidney. The patient responded rapidly to chemotherapy with VACOP-B and rituximab, with a complete resolution of renal failure and of the findings from the PET scan. The patient was in remission for 6 months, while on chemotherapy, before he was found to have recurrence of the disease in cervical lymph nodes and died 1 month later with normal kidney function.