Outcomes of Kidney Transplantation in Patients with Myeloma and Amyloidosis in the USA

Overview

Journal Nephrol Dial Transplant

Publisher Oxford University Press

Specialties General Surgery
Nephrology

Date 2022 Jun 10

PMID 35687020

Authors

Jia H Ng

Stephanie Izard

Naoka Murakami

Kenar D Jhaveri

Amy Sharma

Vinay Nair

Affiliations

Soon will be listed here.

Abstract

Background: Recent improvement in treatment and patient survival has opened the eligibility of kidney transplantation to patients who developed end-stage kidney disease (ESKD) from plasma cell dyscrasias (PCDs). Data on clinical outcomes in this population are lacking.

Methods: We conducted a retrospective study of United Network for Organ Sharing/Organ Procurement and Transplantation Network dataset (2006-2018) to compare patient and graft outcomes of kidney transplant recipients with ESKD due to PCD versus other causes.

Results: Among 168 369 adult first kidney transplant recipients, 0.22-0.43% per year had PCD as the cause of ESKD. The PCD group had worse survival than the non-PCD group for both living and deceased donor types {adjusted hazard ratio [aHR] 2.24 [95% confidence interval (CI) 1.67-2.99] and aHR 1.40 [95% CI 1.08-1.83], respectively}. The PCD group had worse survival than the diabetes group, but only among living donors [aHR 1.87 (95% CI 1.37-2.53) versus aHR 1.16 (95% CI 0.89-1.2)]. Graft survival in patients with PCD were worse than non-PCD in both living and deceased donors [aHR 1.72 (95% CI 1.91-2.56) and aHR 1.30 (95% CI 1.03-1.66)]. Patient and graft survival were worse in amyloidosis but not statistically different in multiple myeloma compared with the non-PCD group.

Conclusion: The study data are crucial when determining kidney transplant eligibility and when discussing transplant risks in patients with PCD.

Citing Articles

Onconephrology 2022: An Update.

Bonilla M, Gudsoorkar P, Wanchoo R, Herrmann S, Jhaveri K Kidney360. 2023; 4(2):258-271.

PMID: 36821617 PMC: 10103386. DOI: 10.34067/KID.0001582022.

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