Kidney Transplantation for Kidney Failure Due to Multiple Myeloma: Case Reports
Kidney Transplantation for Kidney Failure Due to Multiple Myeloma: Case Reports
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DOI：
10.1053/j.ajkd.2016.12.023
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发表时间：
2017-06-01
影响因子：
13.2
通讯作者：
Webber, Allison B.
中科院分区：
文献类型：
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作者：
Le, Thuy X.;Wolf, Jeffrey L.;Webber, Allison B.
移植中心历来认为多发性骨髓瘤病史是肾移植的禁忌症，因为复发率高，移植存活率低。然而，在多发性骨髓瘤的治疗方面已经取得了显着进展，患者生存率提高，这可能使这些患者的肾移植成功。我们报告了2009年至2015年期间在我们机构接受肾移植的4例患者，他们在化疗和自体干细胞移植后获得了非常好的部分缓解或更好的缓解。所有4例患者均接受活体供肾; 2例接受巴利昔单抗诱导治疗，2例接受胸腺球蛋白诱导治疗。1例患者骨髓瘤进展，对治疗反应良好。所有患者在肾移植后1年均具有功能移植。没有患者发生排斥反应或BK多瘤病毒或巨细胞病毒感染，随访时间为肾移植后16至58个月。我们的经验表明，肾移植在一部分多发性骨髓瘤患者中是可行的。未来的研究是必要的，以比较这些患者的结果与其他高风险患者接受肾移植。(C)2017年由国家肾脏基金会，Inc.爱思唯尔公司出版All rights reserved.
Transplantation centers have historically considered a history of multiple myeloma as a contraindication to kidney transplantation due to high recurrence rates and poor transplant survival. However, there have been significant advances in the treatment of multiple myeloma, with improved patient survival, which may allow for successful kidney transplantation in these patients. We report on 4 patients who underwent kidney transplantation at our institution between 2009 and 2015 after having achieved a very good partial response or better with chemotherapy and autologous stem cell transplantation. All 4 patients received kidneys from living donors; 2 underwent induction therapy with basiliximab, and 2,, with thymoglobulin. One patient had progression of myeloma, which responded well to therapy. All had functioning transplants at 1 year after kidney transplantation. No patients experienced a rejection episode or infections with BK polyomavirus or cytomegalovirus, with follow-up ranging from 16 to 58 months after kidney transplantation. Our experience suggests that kidney transplantation is feasible in a subset of patients with multiple myeloma. Future studies are necessary to compare outcomes in these patients with other high-risk patients undergoing kidney transplantation. (C) 2017 by the National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.