Review article: Plasma cell diseases and organ transplant

Status: 
Ready to upload
Record number: 
2035
Estimated frequency: 
(Council of Europe Guidelines 2020): MGUS (monoclonal gammopathy of undetermined significance) with accurate diagnosis and appropriate follow-up without progression to multiple myeloma or related disorders after a definite disease-free interval of 5-10 years may be considered for organ donation and be assumed to pose a low risk for transmission. It might be reasonable to accept an organ donor with a pre-diagnosed MGUS, especially in cases of confirmed MGUS without progression where the diagnosis has been confirmed years before.
Time to detection: 
N/A
Alerting signals, symptoms, evidence of occurrence: 
N/A
Demonstration of imputability or root cause: 
N/A
Imputability grade: 
Not Assessable
Groups audience: 
Suggest new keywords: 
Review article
Deceased donor
Living donor
Malignancy
MGUS (monoclonal gammopathy of unknown significance)
Suggest references: 
Cowan AJ, Johnson CK, Libby EN. Plasma cell diseases and organ transplant: A comprehensive review. Am J Transplant. 2018;18(5):1046-58.
Note: 
Please add the classification of Monoclonal Gammopathy of undetermined significance (MGUS) (or however it is worded) under the Malignancy->Blood and lymphoid classification and change the selection from "lymphoma, B cell other..." to that one. Agree Crl-ludwig 2nd review
Expert comments for publication: 
This article largely deals with evidence-based information on various plasma cell dyscrasias in the recipient, but does also include a section on MGUS (monoclonal gammopathy of undetermined significance) in organ donors. They cite several reports: Serra et al (NDT Plus. 2011;4(4):256-7), in which 2 cases of living donor kidney transplant with donor MGUS did not transmit disease, Felldin et al (Am J Transplant 2016;16(9):2676-83), in which 2 deceased donors with MGUS (diagnosed retrospectively) transmitted 2 lymphoplasmacytic lymphomas, 2 MGUS and 3 multiple myelomas to all 7 organ recipients, and two additional case reports (Grey et al, Br. J Haematol 2000;108(3):592-4 and Peri et al, Am J Transplant 2006;6(2):419-22) of donor origin myeloma arising after kidney transplant. The article also includes guidelines for risk assessment of progression of multiple myeloma, which may be helpful in assessing donors.