Renal transplantation for end-stage renal disease following allo-hematopoietic stem cell transplantation (One case report and literature review)

Objective To explore the clinical features and feasibility of renal transplantation for end-stage renal disease (ESRD) following hematopoietic stem cell transplantation (HSCT). Method A retrospective study was done in one case of renal transplantation for ERSD following HSCT. Clinical manifestations were summarized and prognosis was described. The 22-year-old male recipient had received HLA allele matched related bone marrow transplantation from his sister in 2001 and accepted renal transplantation 14 years after HSCT because of delayed renal dysfunction. Donor was a cardiac death patient, the preoperative Panel Reactive Antibody Testing was negative and there were 1.5 HLA antigen mismatches of 6 HLA-A, B, DR antigens of donor and recipient. The recipient received immunosuppressive therapy of tacrolimus + mycophenolate mofetil + steroid after renal transplantation. Result The patient's renal function remained stable and serum creatinine level was 65 μmol/L. The outcome of the patient was fairly good during the follow-up period of short-term. Conclusion Renal transplant is a feasible alternative for patients with ESRD following HSCT. If the transplanted kidney and abbr. hematopoietic stem cells are from different donors, immunosuppressive treatment is essential after renal transplantation. Long-term follow-up and adjustment of immunosuppression treatment are needed to prevent and treat postoperative complications. Key words: Hematopoietic stem cell transplantation; Kidney transplantation; Prognosis