title: Hematopoietic Cell and Renal Transplantation in Plasma Cell Dyscrasia Patients.
abstract: Gammopathies, multiple myeloma, and amyloidosis are plasma dyscrasias characterized by clonal proliferation and immunoglobulin overproduction. Renal impairment is the most common and serious complication with an incidence of 20-30% patients at the diagnosis. Kidney transplant has not been considered feasible in the presence of plasma dyscrasias because the immunosuppressive therapy may increase the risk of neoplasia progression, and paraproteins may affect the graft. However, recent advances in clinical management of multiple myeloma and other gammopathies allow considering kidney transplant as a possible alternative to dialysis. Numerous evidence indicates the direct relationship between hematological remission and renal function restoring. The combination of kidney and hematopoietic cell transplant has been reported as a promising approach to reestablish end-organ function and effectively treat the underlying disease. This review describes current protocols used to perform kidney transplantation in patients with plasma dyscrasias.
authors.affiliation: Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, St Orsola Hospital, University of Bologna, Bologna, Italy.
authors.forename: Olga
authors.initials: O
authors.lastname: Baraldi
authors.forename: Valeria
authors.initials: V
authors.lastname: Grandinetti
authors.forename: Gabriele
authors.initials: G
authors.lastname: Donati
authors.forename: Giorgia
authors.initials: G
authors.lastname: Comai
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Battaglino
authors.forename: Vania
authors.initials: V
authors.lastname: Cuna
authors.forename: Irene
authors.initials: I
authors.lastname: Capelli
authors.forename: Elisa
authors.initials: E
authors.lastname: Sala
authors.forename: Gaetano
authors.initials: G
authors.lastname: La Manna
mesh_terms: D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000166:cytology; D006801:Humans; D016030:Kidney Transplantation; D010265:Paraproteinemias / Q000628:therapy*