PMID- 34175375
OWN - NLM
STAT- MEDLINE
DCOM- 20220202
LR  - 20230202
IS  - 1523-6838 (Electronic)
IS  - 0272-6386 (Print)
IS  - 0272-6386 (Linking)
VI  - 79
IP  - 2
DP  - 2022 Feb
TI  - Kidney Transplantation in Patients With Monoclonal Gammopathy of Renal 
      Significance (MGRS)-Associated Lesions: A Case Series.
PG  - 202-216
LID - S0272-6386(21)00692-2 [pii]
LID - 10.1053/j.ajkd.2021.04.015 [doi]
AB  - RATIONALE & OBJECTIVE: Data on kidney transplantation outcomes among patients 
      with monoclonal gammopathy of renal significance (MGRS) are lacking. STUDY 
      DESIGN: Case series of patients with MGRS, some of whom received clone-directed 
      therapies before kidney transplantation. SETTING & PARTICIPANTS: 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). FINDINGS: 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. LIMITATIONS: Small sample 
      size, nonstandardized clinical management, retrospective design. CONCLUSIONS: 
      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.
CI  - Copyright (c) 2021 National Kidney Foundation, Inc. Published by Elsevier Inc. All 
      rights reserved.
FAU - Heybeli, Cihan
AU  - Heybeli C
AD  - Division of Nephrology, Mus State Hospital, Mus, Turkey.
FAU - Alexander, Mariam Priya
AU  - Alexander MP
AD  - Divisions of Pathology, Department of Medicine, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Bentall, Andrew J
AU  - Bentall AJ
AD  - Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Amer, Hatem
AU  - Amer H
AD  - Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Buadi, Francis K
AU  - Buadi FK
AD  - Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
FAU - Dean, Patrick G
AU  - Dean PG
AD  - Transplantation Surgery, Department of Medicine, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Dingli, David
AU  - Dingli D
AD  - Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
FAU - Dispenzieri, Angela
AU  - Dispenzieri A
AD  - Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
FAU - El Ters, Mireille
AU  - El Ters M
AD  - Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Gertz, Morie A
AU  - Gertz MA
AD  - Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
FAU - Issa, Naim S
AU  - Issa NS
AD  - Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Kapoor, Prashant
AU  - Kapoor P
AD  - Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
FAU - Kourelis, Taxiarchis
AU  - Kourelis T
AD  - Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
FAU - Kukla, Aleksandra
AU  - Kukla A
AD  - Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Kumar, Shaji
AU  - Kumar S
AD  - Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
FAU - Lacy, Martha Q
AU  - Lacy MQ
AD  - Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
FAU - Lorenz, Elizabeth C
AU  - Lorenz EC
AD  - Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Muchtar, Eli
AU  - Muchtar E
AD  - Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
FAU - Murray, David L
AU  - Murray DL
AD  - Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Nasr, Samih H
AU  - Nasr SH
AD  - Divisions of Pathology, Department of Medicine, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Prieto, Mikel
AU  - Prieto M
AD  - Transplantation Surgery, Department of Medicine, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Rajkumar, S Vincent
AU  - Rajkumar SV
AD  - Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
FAU - Schinstock, Carrie A
AU  - Schinstock CA
AD  - Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Stegall, Mark D
AU  - Stegall MD
AD  - Transplantation Surgery, Department of Medicine, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Warsame, Rahma
AU  - Warsame R
AD  - Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
FAU - Leung, Nelson
AU  - Leung N
AD  - Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, 
      Minnesota; Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota. 
      Electronic address: leung.nelson@mayo.edu.
LA  - eng
GR  - K23 DK123313/DK/NIDDK NIH HHS/United States
GR  - P50 CA186781/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20210624
PL  - United States
TA  - Am J Kidney Dis
JT  - American journal of kidney diseases : the official journal of the National Kidney 
      Foundation
JID - 8110075
SB  - IM
MH  - Humans
MH  - Kidney
MH  - *Kidney Diseases
MH  - *Kidney Transplantation/adverse effects
MH  - *Monoclonal Gammopathy of Undetermined Significance
MH  - *Paraproteinemias/complications
MH  - Retrospective Studies
PMC - PMC8702583
MID - NIHMS1731391
OTO - NOTNLM
OT  - Monoclonal gammopathy of renal significance (MGRS)
OT  - case series
OT  - graft loss
OT  - hematologic response
OT  - kidney transplantation
OT  - plasma cell disorder
OT  - recurrence
OT  - renal transplant
EDAT- 2021/06/28 06:00
MHDA- 2022/02/03 06:00
PMCR- 2023/02/01
CRDT- 2021/06/27 20:41
PHST- 2020/12/24 00:00 [received]
PHST- 2021/04/16 00:00 [accepted]
PHST- 2021/06/28 06:00 [pubmed]
PHST- 2022/02/03 06:00 [medline]
PHST- 2021/06/27 20:41 [entrez]
PHST- 2023/02/01 00:00 [pmc-release]
AID - S0272-6386(21)00692-2 [pii]
AID - 10.1053/j.ajkd.2021.04.015 [doi]
PST - ppublish
SO  - Am J Kidney Dis. 2022 Feb;79(2):202-216. doi: 10.1053/j.ajkd.2021.04.015. Epub 
      2021 Jun 24.