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Abstract: PO2469

National Trends in Kidney Transplantation Among Patients with ESKD from Plasma Cell Dyscrasias

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Ng, Jia Hwei, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
  • Izard, Stephanie, Northwell Health, Great Neck, New York, United States
  • Jhaveri, Kenar D., Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
  • Nair, Vinay, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
Background

Due to relapses and kidney involvement, plasma cell dyscrasias have been a relative contraindication for kidney transplantation. With newer medications and improved prognosis of plasma cell dyscrasias, kidney transplantation in this population is becoming more common. We aimed to describe national trends in the proportion of kidney transplants among recipients who had ESKD from plasma cell dyscrasias (multiple myeloma, amyloidosis, and monoclonal gammopathy of renal significance).

Methods

We used data from the United Network for Organ Sharing/ Organ Procurement and Transplantation Network (UNOS/OPTN) database. Patients 18 years or older, BMI >15 or <45 kg/m2, received a first kidney transplant between January 1, 2006 to December 31, 2017 were eligible. Recipients of more than one organ transplant were excluded.

Results

A total of 160,966 patients received a first kidney transplant. Among these, 487 (0.3%) had ESKD from plasma cell dyscrasia, 45,570 (28.3%) from diabetes mellitus, and 114,909 (71.4%) from other diagnoses. Clinical characteristics of the plasma cell dyscrasia group are as follows: median age 59.0 (IQR 50.0 - 65.0) years, 294 (60.4%) men, 379 (77.8%) White, 19 (3.9%) with diabetes mellitus, median BMI 26.4 (IQR 23.1-29.0) and 53 (10.9 %) pre-emptive transplant. Table 1 shows the national trends of kidney transplants among first time recipients and those with plasma cell dyscrasia. Time series analysis shows an increase of 0.1% (95% CI 0.1 - 0.1) over 12 years in the proportion of kidney transplantation for recipients with ESKD from plasma cell dyscrasias.

Conclusion

Despite improvement in the treatment of plasma cell dyscrasias, national trends show only a small rise in the proportion of kidney transplantation for patients with ESKD from plasma cell dyscrasias. Additional analyses are needed to assess the outcomes of these kidney transplant recipients.