Related Experiment Video
Updated: Jun 30, 2025
Establishment of a Human Multiple Myeloma Xenograft Model in the Chicken to Study Tumor Growth, Invasion and Angiogenesis
Published on: May 1, 2015
Kidney Transplantation in Multiple Myeloma and Monoclonal Gammopathy of Renal Significance
1Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN; Division of Hematology, Mayo Clinic, Rochester, MN.
Abstract:
Recent advances in the treatment of plasma cell disorders (PCDs) have provided a wealth of therapy alternatives and improved overall survival tremendously. Various types of PCDs are associated with kidney injury and end-stage kidney disease in a considerable number of patients. Kidney transplantation (KTx) is the best option for renal replacement therapy in select patients in terms of both quality of life parameters and overall survival. Even with modern therapies, all PCDs carry the risk of hematologic progression, whereas histologic recurrence and graft loss are other prevailing concerns in these patients. The risk of mortality is also higher in some of these disorders compared with KTx recipients who suffer from other causes of kidney disease. Unlike solid cancers, there is no well-defined "waiting time" after hematologic remission before proceeding to KTx. Thus, clinicians are usually reluctant to recommend KTx to patients who develop end-stage kidney disease due to PCDs. This review aims to provide the current evidence on KTx outcomes in patients with monoclonal gammopathy of renal significance and multiple myeloma. Although immunoglobulin light chain amyloidosis is a monoclonal gammopathy of renal significance subtype, KTx outcomes in this group are mentioned in another chapter of this issue.
Insights
Kidney transplantation (KTx) offers improved survival for patients with plasma cell disorders (PCDs) and kidney failure. However, concerns about disease recurrence and mortality risk often lead to reluctance in recommending KTx.
Area of Science:
- Nephrology
- Hematology
- Transplantation Medicine
Background:
- Plasma cell disorders (PCDs) are increasingly associated with kidney injury and end-stage kidney disease.
- Kidney transplantation (KTx) is the optimal renal replacement therapy for select PCD patients, improving quality of life and survival.
- Despite advances, PCDs pose risks of hematologic progression, recurrence, and graft loss post-KTx.
Purpose of the Study:
- To review current evidence on KTx outcomes in patients with monoclonal gammopathy of renal significance and multiple myeloma.
- To address the reluctance in recommending KTx for end-stage kidney disease due to PCDs.
- To provide insights into managing KTx in the context of PCDs.
Main Methods:
- Literature review of studies on KTx outcomes in PCD patients.
- Analysis of data concerning survival, recurrence, and mortality.
- Comparison with KTx recipients with other kidney disease etiologies.
Main Results:
- KTx offers significant survival benefits for select PCD patients.
- PCDs carry a higher mortality risk post-KTx compared to other kidney diseases.
- Lack of defined waiting times post-remission contributes to clinical hesitancy towards KTx.
Conclusions:
- KTx is a viable and beneficial option for select PCD patients with end-stage kidney disease.
- Careful patient selection and risk stratification are crucial for successful KTx in PCD.
- Further research and guidelines are needed to optimize KTx management in PCD.
More Related Videos
Related Concept Videos
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
01:24Tissue Transplantation
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...