Kidney Transplantation in Patients With Monoclonal Gammopathy of Renal Significance (MGRS)–Associated Lesions: A Case Series
Data on kidney transplantation outcomes among patients with monoclonal gammopathy of renal significance (MGRS) are lacking. Case series of patients with MGRS, some of whom received clone-directed therapies before kidney transplantation. 28 patients who underwent kidney transplantation from 1987 thro...
Gespeichert in:
| Veröffentlicht in: | American journal of kidney diseases 2022-02, Vol.79 (2), p.202-216 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 216 |
|---|---|
| container_issue | 2 |
| container_start_page | 202 |
| container_title | American journal of kidney diseases |
| container_volume | 79 |
| creator | Heybeli, Cihan Alexander, Mariam Priya Bentall, Andrew J. Amer, Hatem Buadi, Francis K. Dean, Patrick G. Dingli, David Dispenzieri, Angela El Ters, Mireille Gertz, Morie A. Issa, Naim S. Kapoor, Prashant Kourelis, Taxiarchis Kukla, Aleksandra Kumar, Shaji Lacy, Martha Q. Lorenz, Elizabeth C. Muchtar, Eli Murray, David L. Nasr, Samih H. Prieto, Mikel Rajkumar, S. Vincent Schinstock, Carrie A. Stegall, Mark D. Warsame, Rahma Leung, Nelson |
| description | Data on kidney transplantation outcomes among patients with monoclonal gammopathy of renal significance (MGRS) are lacking.
Case series of patients with MGRS, some of whom received clone-directed therapies before kidney transplantation.
28 patients who underwent kidney transplantation from 1987 through 2016 after diagnosis with MGRS-associated lesions including light-chain deposition disease (LCDD), C3 glomerulopathy with monoclonal gammopathy (C3G-MG), and light-chain proximal tubulopathy (LCPT).
Of the 19 patients with LCDD, 10 were treated before kidney transplantation and 9 were treatment-naive. Among the treated patients with LCDD, 3 (30%) experienced histologic recurrence, 2 (20%) grafts failed, and 2 (20%) died during a median follow-up of 70 (range, 3-162) months after transplant. In the treatment-naive LCDD group, 8 (89%) had histologic recurrence, 6 (67%) grafts failed, and 4 (44%) patients died during a median follow-up of 60 (range, 35-117) months. Of the 5 patients who had a complete response before transplant, none died, and only 1 experienced graft failure, 162 months after transplant. Of 5 patients with C3G-MG, 3 were treatment-naive before transplant. Both patients who were treated before transplant had histologic recurrence, and 1 experienced graft failure and died. Among the 3 patients with treatment-naive C3G-MG, histologic recurrence occurred in all, and graft loss and death were observed in 2 and 1, respectively. In the LCPT group (n=4), histologic recurrence was observed in all 3 patients who did not receive clone-directed therapies before transplant, and 2 of these patients died, 1 with a functioning kidney. The 1 patient with LCPT who received therapy before transplant did not have histologic recurrence or graft loss and survived.
Small sample size, nonstandardized clinical management, retrospective design.
Recurrence is very common in all MGRS-associated lesions after kidney transplant. Achieving a complete hematologic response may reduce the risks of recurrence, graft loss, and death. More studies are needed to determine the effects of hematologic response on outcomes for each MGRS-associated lesion. |
| doi_str_mv | 10.1053/j.ajkd.2021.04.015 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2545996132</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0272638621006922</els_id><sourcerecordid>2545996132</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-82fc50b74003e90cd3c9314902c94390c5fba0742485ecce77202862c1571013</originalsourceid><addsrcrecordid>eNp9kE2OEzEQhS0EYsLABVggL4dFN-W__kFsoggCIiPQJBJLy3FXMw7ddqbtIGWDuAM35CQ4ysCSVVU9vXrS-wh5zqBkoMSrXWl237qSA2clyBKYekBmTHFRVI1oHpIZ8JoXlWiqC_Ikxh0AtKKqHpMLIVmtRK1m5MdH13k80s1kfNwPxieTXPDUefo5b-hTpF9cuqXXwQc7BG8GujTjGPYm3R5p6OkNnrS1--pd76zxFunV9fJm_fL3z1_zGIN1JmFHVxhzbnxN53RhItI1Tg7jU_KoN0PEZ_fzkmzevd0s3herT8sPi_mqsBIgFQ3vrYJtnQ-BLdhO2FYw2QK3rRRZUP3WQC25bBRai3WdoTQVt0zVDJi4JFfn2P0U7g4Ykx5dtDjkvhgOUXMlVdtWTPBs5WernUKME_Z6P7nRTEfNQJ-w650-Ydcn7Bqkztjz04v7_MN2xO7fy1_O2fDmbMBc8rvDSUeb4Vrs3IQ26S64_-X_AdYNk6s</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2545996132</pqid></control><display><type>article</type><title>Kidney Transplantation in Patients With Monoclonal Gammopathy of Renal Significance (MGRS)–Associated Lesions: A Case Series</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Heybeli, Cihan ; Alexander, Mariam Priya ; Bentall, Andrew J. ; Amer, Hatem ; Buadi, Francis K. ; Dean, Patrick G. ; Dingli, David ; Dispenzieri, Angela ; El Ters, Mireille ; Gertz, Morie A. ; Issa, Naim S. ; Kapoor, Prashant ; Kourelis, Taxiarchis ; Kukla, Aleksandra ; Kumar, Shaji ; Lacy, Martha Q. ; Lorenz, Elizabeth C. ; Muchtar, Eli ; Murray, David L. ; Nasr, Samih H. ; Prieto, Mikel ; Rajkumar, S. Vincent ; Schinstock, Carrie A. ; Stegall, Mark D. ; Warsame, Rahma ; Leung, Nelson</creator><creatorcontrib>Heybeli, Cihan ; Alexander, Mariam Priya ; Bentall, Andrew J. ; Amer, Hatem ; Buadi, Francis K. ; Dean, Patrick G. ; Dingli, David ; Dispenzieri, Angela ; El Ters, Mireille ; Gertz, Morie A. ; Issa, Naim S. ; Kapoor, Prashant ; Kourelis, Taxiarchis ; Kukla, Aleksandra ; Kumar, Shaji ; Lacy, Martha Q. ; Lorenz, Elizabeth C. ; Muchtar, Eli ; Murray, David L. ; Nasr, Samih H. ; Prieto, Mikel ; Rajkumar, S. Vincent ; Schinstock, Carrie A. ; Stegall, Mark D. ; Warsame, Rahma ; Leung, Nelson</creatorcontrib><description>Data on kidney transplantation outcomes among patients with monoclonal gammopathy of renal significance (MGRS) are lacking.
Case series of patients with MGRS, some of whom received clone-directed therapies before kidney transplantation.
28 patients who underwent kidney transplantation from 1987 through 2016 after diagnosis with MGRS-associated lesions including light-chain deposition disease (LCDD), C3 glomerulopathy with monoclonal gammopathy (C3G-MG), and light-chain proximal tubulopathy (LCPT).
Of the 19 patients with LCDD, 10 were treated before kidney transplantation and 9 were treatment-naive. Among the treated patients with LCDD, 3 (30%) experienced histologic recurrence, 2 (20%) grafts failed, and 2 (20%) died during a median follow-up of 70 (range, 3-162) months after transplant. In the treatment-naive LCDD group, 8 (89%) had histologic recurrence, 6 (67%) grafts failed, and 4 (44%) patients died during a median follow-up of 60 (range, 35-117) months. Of the 5 patients who had a complete response before transplant, none died, and only 1 experienced graft failure, 162 months after transplant. Of 5 patients with C3G-MG, 3 were treatment-naive before transplant. Both patients who were treated before transplant had histologic recurrence, and 1 experienced graft failure and died. Among the 3 patients with treatment-naive C3G-MG, histologic recurrence occurred in all, and graft loss and death were observed in 2 and 1, respectively. In the LCPT group (n=4), histologic recurrence was observed in all 3 patients who did not receive clone-directed therapies before transplant, and 2 of these patients died, 1 with a functioning kidney. The 1 patient with LCPT who received therapy before transplant did not have histologic recurrence or graft loss and survived.
Small sample size, nonstandardized clinical management, retrospective design.
Recurrence is very common in all MGRS-associated lesions after kidney transplant. Achieving a complete hematologic response may reduce the risks of recurrence, graft loss, and death. More studies are needed to determine the effects of hematologic response on outcomes for each MGRS-associated lesion.</description><identifier>ISSN: 0272-6386</identifier><identifier>ISSN: 1523-6838</identifier><identifier>EISSN: 1523-6838</identifier><identifier>DOI: 10.1053/j.ajkd.2021.04.015</identifier><identifier>PMID: 34175375</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>case series ; graft loss ; hematologic response ; Humans ; Kidney ; Kidney Diseases ; kidney transplantation ; Kidney Transplantation - adverse effects ; Monoclonal gammopathy of renal significance (MGRS) ; Monoclonal Gammopathy of Undetermined Significance ; Paraproteinemias - complications ; plasma cell disorder ; recurrence ; renal transplant ; Retrospective Studies</subject><ispartof>American journal of kidney diseases, 2022-02, Vol.79 (2), p.202-216</ispartof><rights>2021 National Kidney Foundation, Inc.</rights><rights>Copyright © 2021 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-82fc50b74003e90cd3c9314902c94390c5fba0742485ecce77202862c1571013</citedby><cites>FETCH-LOGICAL-c400t-82fc50b74003e90cd3c9314902c94390c5fba0742485ecce77202862c1571013</cites><orcidid>0000-0001-7903-1106 ; 0000-0002-5651-1411</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/j.ajkd.2021.04.015$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34175375$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Heybeli, Cihan</creatorcontrib><creatorcontrib>Alexander, Mariam Priya</creatorcontrib><creatorcontrib>Bentall, Andrew J.</creatorcontrib><creatorcontrib>Amer, Hatem</creatorcontrib><creatorcontrib>Buadi, Francis K.</creatorcontrib><creatorcontrib>Dean, Patrick G.</creatorcontrib><creatorcontrib>Dingli, David</creatorcontrib><creatorcontrib>Dispenzieri, Angela</creatorcontrib><creatorcontrib>El Ters, Mireille</creatorcontrib><creatorcontrib>Gertz, Morie A.</creatorcontrib><creatorcontrib>Issa, Naim S.</creatorcontrib><creatorcontrib>Kapoor, Prashant</creatorcontrib><creatorcontrib>Kourelis, Taxiarchis</creatorcontrib><creatorcontrib>Kukla, Aleksandra</creatorcontrib><creatorcontrib>Kumar, Shaji</creatorcontrib><creatorcontrib>Lacy, Martha Q.</creatorcontrib><creatorcontrib>Lorenz, Elizabeth C.</creatorcontrib><creatorcontrib>Muchtar, Eli</creatorcontrib><creatorcontrib>Murray, David L.</creatorcontrib><creatorcontrib>Nasr, Samih H.</creatorcontrib><creatorcontrib>Prieto, Mikel</creatorcontrib><creatorcontrib>Rajkumar, S. Vincent</creatorcontrib><creatorcontrib>Schinstock, Carrie A.</creatorcontrib><creatorcontrib>Stegall, Mark D.</creatorcontrib><creatorcontrib>Warsame, Rahma</creatorcontrib><creatorcontrib>Leung, Nelson</creatorcontrib><title>Kidney Transplantation in Patients With Monoclonal Gammopathy of Renal Significance (MGRS)–Associated Lesions: A Case Series</title><title>American journal of kidney diseases</title><addtitle>Am J Kidney Dis</addtitle><description>Data on kidney transplantation outcomes among patients with monoclonal gammopathy of renal significance (MGRS) are lacking.
Case series of patients with MGRS, some of whom received clone-directed therapies before kidney transplantation.
28 patients who underwent kidney transplantation from 1987 through 2016 after diagnosis with MGRS-associated lesions including light-chain deposition disease (LCDD), C3 glomerulopathy with monoclonal gammopathy (C3G-MG), and light-chain proximal tubulopathy (LCPT).
Of the 19 patients with LCDD, 10 were treated before kidney transplantation and 9 were treatment-naive. Among the treated patients with LCDD, 3 (30%) experienced histologic recurrence, 2 (20%) grafts failed, and 2 (20%) died during a median follow-up of 70 (range, 3-162) months after transplant. In the treatment-naive LCDD group, 8 (89%) had histologic recurrence, 6 (67%) grafts failed, and 4 (44%) patients died during a median follow-up of 60 (range, 35-117) months. Of the 5 patients who had a complete response before transplant, none died, and only 1 experienced graft failure, 162 months after transplant. Of 5 patients with C3G-MG, 3 were treatment-naive before transplant. Both patients who were treated before transplant had histologic recurrence, and 1 experienced graft failure and died. Among the 3 patients with treatment-naive C3G-MG, histologic recurrence occurred in all, and graft loss and death were observed in 2 and 1, respectively. In the LCPT group (n=4), histologic recurrence was observed in all 3 patients who did not receive clone-directed therapies before transplant, and 2 of these patients died, 1 with a functioning kidney. The 1 patient with LCPT who received therapy before transplant did not have histologic recurrence or graft loss and survived.
Small sample size, nonstandardized clinical management, retrospective design.
Recurrence is very common in all MGRS-associated lesions after kidney transplant. Achieving a complete hematologic response may reduce the risks of recurrence, graft loss, and death. More studies are needed to determine the effects of hematologic response on outcomes for each MGRS-associated lesion.</description><subject>case series</subject><subject>graft loss</subject><subject>hematologic response</subject><subject>Humans</subject><subject>Kidney</subject><subject>Kidney Diseases</subject><subject>kidney transplantation</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Monoclonal gammopathy of renal significance (MGRS)</subject><subject>Monoclonal Gammopathy of Undetermined Significance</subject><subject>Paraproteinemias - complications</subject><subject>plasma cell disorder</subject><subject>recurrence</subject><subject>renal transplant</subject><subject>Retrospective Studies</subject><issn>0272-6386</issn><issn>1523-6838</issn><issn>1523-6838</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE2OEzEQhS0EYsLABVggL4dFN-W__kFsoggCIiPQJBJLy3FXMw7ddqbtIGWDuAM35CQ4ysCSVVU9vXrS-wh5zqBkoMSrXWl237qSA2clyBKYekBmTHFRVI1oHpIZ8JoXlWiqC_Ikxh0AtKKqHpMLIVmtRK1m5MdH13k80s1kfNwPxieTXPDUefo5b-hTpF9cuqXXwQc7BG8GujTjGPYm3R5p6OkNnrS1--pd76zxFunV9fJm_fL3z1_zGIN1JmFHVxhzbnxN53RhItI1Tg7jU_KoN0PEZ_fzkmzevd0s3herT8sPi_mqsBIgFQ3vrYJtnQ-BLdhO2FYw2QK3rRRZUP3WQC25bBRai3WdoTQVt0zVDJi4JFfn2P0U7g4Ykx5dtDjkvhgOUXMlVdtWTPBs5WernUKME_Z6P7nRTEfNQJ-w650-Ydcn7Bqkztjz04v7_MN2xO7fy1_O2fDmbMBc8rvDSUeb4Vrs3IQ26S64_-X_AdYNk6s</recordid><startdate>202202</startdate><enddate>202202</enddate><creator>Heybeli, Cihan</creator><creator>Alexander, Mariam Priya</creator><creator>Bentall, Andrew J.</creator><creator>Amer, Hatem</creator><creator>Buadi, Francis K.</creator><creator>Dean, Patrick G.</creator><creator>Dingli, David</creator><creator>Dispenzieri, Angela</creator><creator>El Ters, Mireille</creator><creator>Gertz, Morie A.</creator><creator>Issa, Naim S.</creator><creator>Kapoor, Prashant</creator><creator>Kourelis, Taxiarchis</creator><creator>Kukla, Aleksandra</creator><creator>Kumar, Shaji</creator><creator>Lacy, Martha Q.</creator><creator>Lorenz, Elizabeth C.</creator><creator>Muchtar, Eli</creator><creator>Murray, David L.</creator><creator>Nasr, Samih H.</creator><creator>Prieto, Mikel</creator><creator>Rajkumar, S. Vincent</creator><creator>Schinstock, Carrie A.</creator><creator>Stegall, Mark D.</creator><creator>Warsame, Rahma</creator><creator>Leung, Nelson</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7903-1106</orcidid><orcidid>https://orcid.org/0000-0002-5651-1411</orcidid></search><sort><creationdate>202202</creationdate><title>Kidney Transplantation in Patients With Monoclonal Gammopathy of Renal Significance (MGRS)–Associated Lesions: A Case Series</title><author>Heybeli, Cihan ; Alexander, Mariam Priya ; Bentall, Andrew J. ; Amer, Hatem ; Buadi, Francis K. ; Dean, Patrick G. ; Dingli, David ; Dispenzieri, Angela ; El Ters, Mireille ; Gertz, Morie A. ; Issa, Naim S. ; Kapoor, Prashant ; Kourelis, Taxiarchis ; Kukla, Aleksandra ; Kumar, Shaji ; Lacy, Martha Q. ; Lorenz, Elizabeth C. ; Muchtar, Eli ; Murray, David L. ; Nasr, Samih H. ; Prieto, Mikel ; Rajkumar, S. Vincent ; Schinstock, Carrie A. ; Stegall, Mark D. ; Warsame, Rahma ; Leung, Nelson</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-82fc50b74003e90cd3c9314902c94390c5fba0742485ecce77202862c1571013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>case series</topic><topic>graft loss</topic><topic>hematologic response</topic><topic>Humans</topic><topic>Kidney</topic><topic>Kidney Diseases</topic><topic>kidney transplantation</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Monoclonal gammopathy of renal significance (MGRS)</topic><topic>Monoclonal Gammopathy of Undetermined Significance</topic><topic>Paraproteinemias - complications</topic><topic>plasma cell disorder</topic><topic>recurrence</topic><topic>renal transplant</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Heybeli, Cihan</creatorcontrib><creatorcontrib>Alexander, Mariam Priya</creatorcontrib><creatorcontrib>Bentall, Andrew J.</creatorcontrib><creatorcontrib>Amer, Hatem</creatorcontrib><creatorcontrib>Buadi, Francis K.</creatorcontrib><creatorcontrib>Dean, Patrick G.</creatorcontrib><creatorcontrib>Dingli, David</creatorcontrib><creatorcontrib>Dispenzieri, Angela</creatorcontrib><creatorcontrib>El Ters, Mireille</creatorcontrib><creatorcontrib>Gertz, Morie A.</creatorcontrib><creatorcontrib>Issa, Naim S.</creatorcontrib><creatorcontrib>Kapoor, Prashant</creatorcontrib><creatorcontrib>Kourelis, Taxiarchis</creatorcontrib><creatorcontrib>Kukla, Aleksandra</creatorcontrib><creatorcontrib>Kumar, Shaji</creatorcontrib><creatorcontrib>Lacy, Martha Q.</creatorcontrib><creatorcontrib>Lorenz, Elizabeth C.</creatorcontrib><creatorcontrib>Muchtar, Eli</creatorcontrib><creatorcontrib>Murray, David L.</creatorcontrib><creatorcontrib>Nasr, Samih H.</creatorcontrib><creatorcontrib>Prieto, Mikel</creatorcontrib><creatorcontrib>Rajkumar, S. Vincent</creatorcontrib><creatorcontrib>Schinstock, Carrie A.</creatorcontrib><creatorcontrib>Stegall, Mark D.</creatorcontrib><creatorcontrib>Warsame, Rahma</creatorcontrib><creatorcontrib>Leung, Nelson</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of kidney diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Heybeli, Cihan</au><au>Alexander, Mariam Priya</au><au>Bentall, Andrew J.</au><au>Amer, Hatem</au><au>Buadi, Francis K.</au><au>Dean, Patrick G.</au><au>Dingli, David</au><au>Dispenzieri, Angela</au><au>El Ters, Mireille</au><au>Gertz, Morie A.</au><au>Issa, Naim S.</au><au>Kapoor, Prashant</au><au>Kourelis, Taxiarchis</au><au>Kukla, Aleksandra</au><au>Kumar, Shaji</au><au>Lacy, Martha Q.</au><au>Lorenz, Elizabeth C.</au><au>Muchtar, Eli</au><au>Murray, David L.</au><au>Nasr, Samih H.</au><au>Prieto, Mikel</au><au>Rajkumar, S. Vincent</au><au>Schinstock, Carrie A.</au><au>Stegall, Mark D.</au><au>Warsame, Rahma</au><au>Leung, Nelson</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Kidney Transplantation in Patients With Monoclonal Gammopathy of Renal Significance (MGRS)–Associated Lesions: A Case Series</atitle><jtitle>American journal of kidney diseases</jtitle><addtitle>Am J Kidney Dis</addtitle><date>2022-02</date><risdate>2022</risdate><volume>79</volume><issue>2</issue><spage>202</spage><epage>216</epage><pages>202-216</pages><issn>0272-6386</issn><issn>1523-6838</issn><eissn>1523-6838</eissn><abstract>Data on kidney transplantation outcomes among patients with monoclonal gammopathy of renal significance (MGRS) are lacking.
Case series of patients with MGRS, some of whom received clone-directed therapies before kidney transplantation.
28 patients who underwent kidney transplantation from 1987 through 2016 after diagnosis with MGRS-associated lesions including light-chain deposition disease (LCDD), C3 glomerulopathy with monoclonal gammopathy (C3G-MG), and light-chain proximal tubulopathy (LCPT).
Of the 19 patients with LCDD, 10 were treated before kidney transplantation and 9 were treatment-naive. Among the treated patients with LCDD, 3 (30%) experienced histologic recurrence, 2 (20%) grafts failed, and 2 (20%) died during a median follow-up of 70 (range, 3-162) months after transplant. In the treatment-naive LCDD group, 8 (89%) had histologic recurrence, 6 (67%) grafts failed, and 4 (44%) patients died during a median follow-up of 60 (range, 35-117) months. Of the 5 patients who had a complete response before transplant, none died, and only 1 experienced graft failure, 162 months after transplant. Of 5 patients with C3G-MG, 3 were treatment-naive before transplant. Both patients who were treated before transplant had histologic recurrence, and 1 experienced graft failure and died. Among the 3 patients with treatment-naive C3G-MG, histologic recurrence occurred in all, and graft loss and death were observed in 2 and 1, respectively. In the LCPT group (n=4), histologic recurrence was observed in all 3 patients who did not receive clone-directed therapies before transplant, and 2 of these patients died, 1 with a functioning kidney. The 1 patient with LCPT who received therapy before transplant did not have histologic recurrence or graft loss and survived.
Small sample size, nonstandardized clinical management, retrospective design.
Recurrence is very common in all MGRS-associated lesions after kidney transplant. Achieving a complete hematologic response may reduce the risks of recurrence, graft loss, and death. More studies are needed to determine the effects of hematologic response on outcomes for each MGRS-associated lesion.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34175375</pmid><doi>10.1053/j.ajkd.2021.04.015</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0001-7903-1106</orcidid><orcidid>https://orcid.org/0000-0002-5651-1411</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0272-6386 |
| ispartof | American journal of kidney diseases, 2022-02, Vol.79 (2), p.202-216 |
| issn | 0272-6386 1523-6838 1523-6838 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2545996132 |
| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | case series graft loss hematologic response Humans Kidney Kidney Diseases kidney transplantation Kidney Transplantation - adverse effects Monoclonal gammopathy of renal significance (MGRS) Monoclonal Gammopathy of Undetermined Significance Paraproteinemias - complications plasma cell disorder recurrence renal transplant Retrospective Studies |
| title | Kidney Transplantation in Patients With Monoclonal Gammopathy of Renal Significance (MGRS)–Associated Lesions: A Case Series |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-21T16%3A59%3A54IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Kidney%20Transplantation%20in%20Patients%20With%20Monoclonal%20Gammopathy%20of%20Renal%20Significance%20(MGRS)%E2%80%93Associated%20Lesions:%20A%20Case%20Series&rft.jtitle=American%20journal%20of%20kidney%20diseases&rft.au=Heybeli,%20Cihan&rft.date=2022-02&rft.volume=79&rft.issue=2&rft.spage=202&rft.epage=216&rft.pages=202-216&rft.issn=0272-6386&rft.eissn=1523-6838&rft_id=info:doi/10.1053/j.ajkd.2021.04.015&rft_dat=%3Cproquest_cross%3E2545996132%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2545996132&rft_id=info:pmid/34175375&rft_els_id=S0272638621006922&rfr_iscdi=true |