Kidney transplantation for treatment of end-stage kidney disease after haematopoietic stem cell transplantation: case series and literature review.
Adolescent
Adult
Allografts
/ physiology
Child
Female
Graft vs Host Disease
/ etiology
Hematologic Diseases
/ complications
Hematopoietic Stem Cell Transplantation
Humans
Immunosuppression Therapy
/ methods
Immunosuppressive Agents
/ therapeutic use
Infections
/ etiology
Kidney Failure, Chronic
/ complications
Kidney Transplantation
Male
Middle Aged
Retrospective Studies
Survival Rate
Treatment Outcome
Young Adult
Bone marrow transplantation
GVHD
Infection
Leukemia
Malignancy
Rejection
Journal
Clinical and experimental nephrology
ISSN: 1437-7799
Titre abrégé: Clin Exp Nephrol
Pays: Japan
ID NLM: 9709923
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
08
06
2018
accepted:
13
11
2018
pubmed:
26
12
2018
medline:
30
7
2019
entrez:
26
12
2018
Statut:
ppublish
Résumé
The safety of kidney transplantation (KT) for end-stage kidney disease (ESKD) after haematopoietic stem cell transplantation (HSCT) for haematological disease has not been investigated thoroughly. In this retrospective multicentre study, we investigated the clinical courses of six ESKD patients that received KT after HSCT for various haematological diseases. Data for six such patients were obtained from three institutions in our consortium. Two patients with chronic myeloid leukaemia, one with refractory aplastic anaemia and another one with acute lymphocytic leukaemia received bone marrow transplantation. One patients with acute lymphocytic leukaemia received umbilical cord blood transplantation, and one with mantle cell lymphoma received peripheral blood stem cell transplantation. The patients developed ESKD at a median of 133 months after HSCT. Two patients who received KT and HSCT from the same donor were temporarily treated with immunosuppressive drugs. The other patients received KT and HSCT from different donors and were treated with antibody induction using our standard regimens. For one patient with ABO-incompatible transplantation, we added rituximab, splenectomy, and plasmapheresis. In the observational period at a median of 51 months after KT, only one patient experienced acute T-cell-mediated rejection. Four patients underwent hospitalization because of infection and fully recovered. No patient experienced recurrence of their original haematological disease. All patients survived throughout the observational periods, and graft functions were preserved. Despite the high infection frequency, survival rates and graft functions were extremely good in patients compared with previous studies. Therefore, current management contributed to favourable outcomes of these patients.
Sections du résumé
BACKGROUND
BACKGROUND
The safety of kidney transplantation (KT) for end-stage kidney disease (ESKD) after haematopoietic stem cell transplantation (HSCT) for haematological disease has not been investigated thoroughly.
METHODS
METHODS
In this retrospective multicentre study, we investigated the clinical courses of six ESKD patients that received KT after HSCT for various haematological diseases. Data for six such patients were obtained from three institutions in our consortium.
RESULTS
RESULTS
Two patients with chronic myeloid leukaemia, one with refractory aplastic anaemia and another one with acute lymphocytic leukaemia received bone marrow transplantation. One patients with acute lymphocytic leukaemia received umbilical cord blood transplantation, and one with mantle cell lymphoma received peripheral blood stem cell transplantation. The patients developed ESKD at a median of 133 months after HSCT. Two patients who received KT and HSCT from the same donor were temporarily treated with immunosuppressive drugs. The other patients received KT and HSCT from different donors and were treated with antibody induction using our standard regimens. For one patient with ABO-incompatible transplantation, we added rituximab, splenectomy, and plasmapheresis. In the observational period at a median of 51 months after KT, only one patient experienced acute T-cell-mediated rejection. Four patients underwent hospitalization because of infection and fully recovered. No patient experienced recurrence of their original haematological disease. All patients survived throughout the observational periods, and graft functions were preserved.
CONCLUSIONS
CONCLUSIONS
Despite the high infection frequency, survival rates and graft functions were extremely good in patients compared with previous studies. Therefore, current management contributed to favourable outcomes of these patients.
Identifiants
pubmed: 30584654
doi: 10.1007/s10157-018-1672-1
pii: 10.1007/s10157-018-1672-1
doi:
Substances chimiques
Immunosuppressive Agents
0
Types de publication
Journal Article
Multicenter Study
Review
Langues
eng
Pagination
561-568Investigateurs
Kazunari Tanabe
(K)
Hideki Ishida
(H)
Masashi Inui
(M)
Kazuya Omoto
(K)
Tomokazu Shimizu
(T)
Masayoshi Okumi
(M)
Toshihito Hirai
(T)
Daisuke Toki
(D)
Kohei Unagami
(K)
Hiroshi Toma
(H)
Hiroki Shirakawa
(H)
Yasuhiro Okabe
(Y)
Atsuchi Doi
(A)
Keizo Kaku
(K)
Kei Kurihara
(K)
Ota Morihito
(O)
Références
Nephrol Dial Transplant. 2010 Jan;25(1):278-82
pubmed: 19762604
Bone Marrow Transplant. 1988 Jul;3(4):339-47
pubmed: 2844348
Am J Transplant. 2003 Mar;3(3):301-5
pubmed: 12614285
J Am Soc Nephrol. 2002 Mar;13(3):769-72
pubmed: 11856783
Pediatr Nephrol. 2002 Dec;17(12):1032-7
pubmed: 12478353
Transplantation. 2017 Jun;101(6):1416-1422
pubmed: 27391195
Clin Transplant. 1999 Aug;13(4):330-5
pubmed: 10485375
Transpl Int. 2013 Jun;26(6):576-89
pubmed: 23517251
Ann Intern Med. 1991 Jun 1;114(11):954-5
pubmed: 2024863
Cancer. 1991 Jun 1;67(11):2795-800
pubmed: 2025844
Cancer. 2008 Oct 1;113(7):1580-7
pubmed: 18704986
Clin J Am Soc Nephrol. 2016 Mar 7;11(3):497-504
pubmed: 26728589
Transplantation. 2015 Sep;99(9):e162
pubmed: 26308423
N Engl J Med. 2008 Jan 24;358(4):362-8
pubmed: 18216356
Am J Transplant. 2011 Jan;11(1):156-62
pubmed: 21199355
N Engl J Med. 1999 Dec 2;341(23):1725-30
pubmed: 10580071
Transplantation. 1995 Jun 15;59(11):1633-5
pubmed: 7778182
Kidney Int. 1993 Jul;44(1):221-36
pubmed: 8394951
Lancet. 1994 Mar 26;343(8900):800
pubmed: 7907762
J Am Soc Nephrol. 1998 Nov;9(11):2135-41
pubmed: 9808102
Int J Urol. 2007 Nov;14(11):1044-5
pubmed: 17956534
JAMA. 1993 Sep 15;270(11):1339-43
pubmed: 8360969
Am J Kidney Dis. 1994 Jul;24(1):59-64
pubmed: 8023825
Transpl Int. 2014 Sep;27(9):e92-3
pubmed: 24697965
J Clin Oncol. 1996 Feb;14(2):579-85
pubmed: 8636774
N Engl J Med. 1997 Mar 27;336(13):897-904
pubmed: 9070469
Am J Kidney Dis. 2000 Sep;36(3):474-80
pubmed: 10977778
Transplant Proc. 2011 Jun;43(5):1551-8
pubmed: 21693233
Transplantation. 1994 Dec 27;58(12):1420-2
pubmed: 7809937
Am J Transplant. 2014 Feb;14(2):272-83
pubmed: 24472190
N Engl J Med. 2008 Jan 24;358(4):353-61
pubmed: 18216355