Solid Organ Transplantation After Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective, Multicenter Study of the EBMT

Abstract

To analyze the outcome of solid organ transplantation (SOT) in patients who had undergone allogeneic hematopoietic stem cell transplantation (HSCT), a questionnaire survey was carried out within 107 European Group of Blood and Marrow Transplantation centers. This study covered HSCT between 1984 and 2007 in Europe. Forty-five SOT in 40 patients were reported. Fifteen liver, 15 renal, 13 lung, 1 heart and 1 skin transplantations were performed in 28 centers. Overall survival (OS) of patients after SOT was 78% at 5 years (95% confidence interval [CI], 64% to 92%). OS at 5 years was 100% for renal, 71% (95% CI, 46% to 96%) for liver and 63% (95% CI, 23% to 100%) for lung transplant recipients. The 2-year-incidence of SOT failure was 20% (95% CI, 4% to 36%) in patients with graft-versus-host disease (GvHD) and 7% (95% CI, 0% to 21%) in patients without GvHD before SOT. The relapse incidence for underlying malignant diseases was 4% at 5 years (95% CI, 0% to 12%). In summary, this study shows that selected patients receiving SOT after HSCT have a remarkably good overall and organ survival. These data indicate that SOT should be considered in selected patients with single organ failure after HSCT.

GVHD-associated chronic kidney disease after allogeneic haematopoietic cell transplantation

“…In an EBMT study, 15 renal solid organ transplantations were performed after HCT with 100% OS at 5 years, in a period covering HCT between 1984 and 2007. 41 These reports reflect the growing number of patients with CKD that need to be treated with solid organ transplantation.…”

Small airways diseases, excluding asthma and COPD: an overview

“…Inhaled steroids and long-acting bronchodilators may improve lung function and pulmonary symptoms, and have very limited side-effects [153][154][155]. Lung transplantation may be proposed in selected patients without active chronic extrapulmonary GVH disease [156].…”

Allogeneic transplantation of hematopoietic stem cells and solid organ in the same patient: an update

“…The described recent publications show that the outcomes can be quite good. In a previous survey [13], the 5-year survival of patients receiving a renal transplantation was 100 %, with no patient being on dialysis. The 5-year survival for liver transplantation was 71% and that for lung transplantation 63%.…”

“…Until recent years the literature of such transplantations consisted mainly of case reports as reviewed elsewhere [1,3,13], with the obvious risk of publication bias. This paper aims at updating recent clinical experience with HSCT and SOT in the same patients.…”

“…Koenecke et al [13] carried out a survey among 107 EBMT (European Society for Blood and Marrow Transplantation) centres, with 67000 allogeneic transplantations performed during the study period of 1984-2007. In 28 centres a total of 45 SOTs had been carried out in 40 patients who had previously undergone allogeneic HSCT, of them 15 renal, 15 liver, 13 lung, 1 heart and 1 skin transplantation.…”