Long-term Outcomes of Sequential Hematopoietic Stem Cell Transplantation and Kidney Transplantation: Single-center Experience. Issue 7 (July 2021)

• Record Type: Journal Article
• Authors: Moreira, Carla Leal; Hasib Sidiqi, M.; Buadi, Francis K.; Litzow, Mark R.; Gertz, Morie A.; Dispenzieri, Angela; Russell, Stephen J.; Ansell, Stephen M.; Stegall, Mark D.; Prieto, Mikel; Dean, Patrick G.; Nyberg, Scott L.; El Ters, Mireille; Hogan, William J.; Amer, Hatem; Cosio, Fernando G.; Leung, Nelson
• Is Part Of: Transplantation. Volume 105:Issue 7(2021)
• Publication Date: 2021-07
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation immunology -- Periodicals; 617.95
• DOI: 10.1097/TP.0000000000003477
• Languages: English
• ISSNs: 0041-1337

Abstract

Abstract : Background: Experience with sequential hematopoietic stem cell transplant (HSCT) and kidney transplant (KT) is limited. Methods: We conducted a retrospective observational study of adult patients who underwent both HSCT and KT at our center, with a median follow-up of 11 y. Results: In our 54 patients cohort (94% autologous HSCT), 36 (67%) patients received HSCT first followed by KT, while 18 (33%) received KT before HSCT. In both groups, AL amyloidosis represented 50% of hematologic diagnosis. Only 4 patients expired due to hematologic disease relapse (2 patients in each group) and only 3 allografts were lost due to hematologic disease recurrence (HSCT first n = 1 and KT first n = 2). Overall 1, 5, and 10 y death-censored graft survival rates were 94%, 94%, and 94%, respectively, for the HSCT first group and 89%, 89%, and 75%, respectively, for the KT first group. Overall 1, 5, and 10 y patients survival rates were 100%, 97% and 90%, respectively, for the HSCT first group and 100%, 76%, and 63%, respectively, for the KT first group. Conclusions: Our study supports safety of sequential KT and HSCT, with improved overall patient survival compared to recipients of HSCT remaining on dialysis and good long-term kidney allograft outcome.