title: Monoclonal gammopathy after liver transplantation: a risk factor for long-term medical complications other than malignancies.
abstract: The aims of the study were to evaluate (i) the prevalence of MGUS in patients after liver transplantation (LT), (ii) the role of MGUS as a risk factor for malignancy and other medical complications after LT. One hundred and fifty consecutive patients were included in the study and followed prospectively after LT for more than 18 months. Eighteen patients had MGUS before LT, whereas 49 patients developed MGUS after LT ('de novo' MGUS). Thirty-six of these patients showed a MGUS along all the follow up after LT ('permanent' MGUS). In 31 patients, MGUS disappeared after LT ('transient' MGUS). No patient with MGUS developed B-malignant lymphoproliferative disorder and only one patient developed a myeloma after LT. Comparing patients with 'permanent' MGUS to patients with 'transient' MGUS or without MGUS after LT, the former group showed a higher rate of serious infections (30% versus 13%, P = 0.01), chronic kidney disease (CKD) (75% versus 44%, P = 0.001) and mortality (33% versus 17%, P = 0.04). Permanent MGUS was confirmed as an independent risk factor for serious infections and CKD by multivariate analysis. Permanent MGUS after LT does not entail a significant risk of malignancy, but it is associated with a higher risk of serious infections and CKD.
authors: Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy.
authors: Alessandra
authors: A
authors: Galioto
authors: Filippo
authors: F
authors: Morando
authors: Silvia
authors: S
authors: Rosi
authors: Mirko
authors: M
authors: Schipilliti
authors: Silvano
authors: S
authors: Fasolato
authors: Marta
authors: M
authors: Magrin
authors: Anna Chiara
authors: AC
authors: Frigo
authors: Fausto
authors: F
authors: Adami
authors: Marta
authors: M
authors: Cavallin
authors: Giacomo
authors: G
authors: Zanus
authors: Mario
authors: M
authors: Plebani
authors: Antonietta
authors: A
authors: Romano
authors: Antonietta
authors: A
authors: Sticca
authors: Umberto
authors: U
authors: Cillo
authors: Angelo
authors: A
authors: Gatta
authors: Paolo
authors: P
authors: Angeli
mesh_terms: D000368:Aged; D001424:Bacterial Infections / Q000209:etiology; D019075:Electrophoresis, Capillary / Q000379:methods; D005260:Female; D005355:Fibrosis / Q000601:surgery* / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000209:etiology* / Q000628:therapy; D009101:Multiple Myeloma / Q000628:therapy; D010265:Paraproteinemias / Q000209:etiology*; D012306:Risk; D012307:Risk Factors; D014777:Virus Diseases / Q000209:etiology
chemical_list: D007166:Immunosuppressive Agents