Nephrol Dial Transplant. 2022 Jun 10:gfac196. doi: 10.1093/ndt/gfac196. Online ahead of print.
ABSTRACT
BACKGROUND: Recent improvement in treatment and patient survival has opened the eligibility of kidney transplantation for patients who developed end-stage kidney disease (ESKD) from plasma cell dyscrasias (PCD). Data on clinical outcomes in this population is lacking.
METHODS: We conducted a retrospective study of UNOS/OPTN dataset (2006-2018) to compare patient and graft outcomes of kidney transplant recipients with ESKD due to PCD vs other causes.
RESULTS: Among 168 369 first kidney transplant adult 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% CI: 1.67, 2.99]) and (aHR: 1.40 [1.08, 1.83), respectively. The PCD group had worse survival than the diabetes group, but only among living donor type (aHR: 1.87 [1.37, 2.53]) vs (aHR: 1.16, [0.89, 1.2]). Graft survival in patients with PCD were worse than non-PCD in both living and deceased donor type (aHR 1.72 [1.91, 2.56], aHR 1.30 [1.03, 1.66]). Patient and graft survival were worse in amyloidosis but not statistically different in multiple myeloma, compared to non-PCD group.
CONCLUSION: The study data is crucial when determining kidney transplant eligibility and when discussing transplant risk in patients with PCD.
PMID:35687020 | DOI:10.1093/ndt/gfac196