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Abstract: SA-PO122

Outcomes of Kidney Transplantation in Patients With Myeloma and Amyloidosis

Session Information

Category: Onconephrology

  • 1600 Onconephrology

Authors

  • Ng, Jia Hwei, Northwell Health, Great Neck, New York, United States
  • Murakami, Naoka, Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Sharma, Amy, Northwell Health, Great Neck, New York, United States
  • Nair, Vinay, Northwell Health, Great Neck, New York, United States
  • Jhaveri, Kenar D., Northwell Health, Great Neck, New York, United States
Background

Recent improvement in treatment and patient survival has opened the eligibility of kidney transplantation for patients with ESKD due to plasma cell dyscrasias (PCD), such as multiple myeloma, AL amyloidosis and MGRS.

Methods

We conducted a retrospective study of UNOS database (2006-2018) to compare patient and graft outcomes of kidney transplant recipients with ESKD due to PCD vs other causes. The primary outcome was patient survival time, defined as the time from transplantation to death. Secondary outcomes included death-censored graft survival time. First, we described the frequency of transplant in ESRD from various forms of PCD. Also, we determined the absolute and relative outcomes of kidney transplant recipients who had 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, (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 provides novel data on survival in patients with PCD who received kidney transplant. More study are needed to determine the specific group of patients with PCD who benefit from kidney transplant.

Patient survival, stratified by PCD Panel A. Among living donor recipients. Panel B. Among deceased donor recipients.