PMID- 9772924
OWN - NLM
STAT- MEDLINE
DCOM- 19981029
LR  - 20220311
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 77
IP  - 5
DP  - 1998 Sep
TI  - Outcomes of recipients of both bone marrow and solid organ transplants. A review.
PG  - 355-69
AB  - In this review we examine the clinical outcomes of patients who have received 
      both bone marrow transplantation (BMT) and solid organ transplantation (SOT) and 
      discuss the possible immunologic consequences of the dual transplants. We 
      collected cases through a comprehensive literature search (MEDLINE database, 
      English literature only) covering the years 1990 through 1997 and correspondence 
      with the International Bone Marrow Transplant Registry. Our study selected case 
      reports of patients who have undergone both bone marrow and solid organ 
      transplants; cases in which bone marrow transplantation was undertaken as an 
      adjunct ot induce or augment donor-specific tolerance in a recipient to the 
      transplanted organ were excluded. Clinical characteristics included patient's 
      demographic information, underlying disorders for each transplant, source of 
      donor organ or tissue, time between transplants, and immunosuppressive regimens 
      used to prevent graft-versus-host disease (GVHD) or graft rejection. Clinical 
      outcomes included patient survival, complications of transplantation, and 
      donor-specific tolerance that was experienced in many cases. Twenty-one cases of 
      SOT after BMT and 7 cases of BMT after SOT were reviewed. Solid organ 
      transplantations included lung, liver, cardiac, and kidney for a variety of 
      BMT-related complications including GVHD, hepatic veno-occlusive disease, chronic 
      renal failure, end-stage pulmonary disease, and severe cardiomyopathy. Bone 
      marrow transplants were performed following SOT for aplastic anemia and 
      hematologic malignancies. Clinical outcomes for patients who received both BMT 
      and SOT were variable and depended on transplant indication and degree of 
      histocompatibility. Prior bone marrow transplantation may tolerize for a 
      subsequent organ transplant from the same donor. Conversely, severe GVHD may 
      follow BMT from human leukocyte antigen (HLA)-matched donors following SOT. The 
      favorable survival in this high-risk group of patients may represent a literature 
      review bias (that is, an undetermined number of unsuccessful cases may not have 
      been reported). Nonetheless, dual transplantation is clearly feasible in selected 
      cases.
FAU - Dey, B
AU  - Dey B
AD  - Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
FAU - Sykes, M
AU  - Sykes M
FAU - Spitzer, T R
AU  - Spitzer TR
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - *Bone Marrow Transplantation/adverse effects/immunology
MH  - Cardiomyopathies/etiology/surgery
MH  - Graft vs Host Disease/etiology
MH  - Humans
MH  - Immune Tolerance
MH  - Kidney Failure, Chronic/etiology
MH  - Liver Failure/etiology/surgery
MH  - Lung Diseases/etiology/surgery
MH  - *Organ Transplantation
MH  - Transplantation Immunology
MH  - Treatment Outcome
RF  - 107
EDAT- 1998/10/17 00:00
MHDA- 1998/10/17 00:01
CRDT- 1998/10/17 00:00
PHST- 1998/10/17 00:00 [pubmed]
PHST- 1998/10/17 00:01 [medline]
PHST- 1998/10/17 00:00 [entrez]
AID - 10.1097/00005792-199809000-00005 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 1998 Sep;77(5):355-69. doi: 
      10.1097/00005792-199809000-00005.