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Am J Transplant. 2018 Dec 26. doi: 10.1111/ajt.15240. [Epub ahead of print]

Solid organ transplantation after haematopoietic stem cell transplantation in childhood: a multicentric retrospective survey.

Author information

1
HSCT Unit, Hematology-Oncology, IRCSS Istituto G Gaslini, Genova, Italy.
2
Dipartimento di Onco-Ematologia Pediatrica, IRCSS Ospedale Pediatrico Bambino Gesù, Rome, Italy.
3
Division of Stem Cell Transplantation and Regenerative Medicine, Department of Pediatrics, School of Medicine, Stanford University, CA.
4
EBMT Pediatric Disease Working Party, Paris, France.
5
Department for Children and Adolescents, Rigshospitalet, Copenhagen University Hospital, Denmark.
6
Department of Pediatrics, University Medical Center Ulm.
7
Institute of Cellular Medicine Pediatric Immunology Dept, Newcastle University, Great North Children's' Hospital, Newcastle-upon-Tyne, UK.
8
University Hospital Münster, Pediatric Hematology and Oncology, Muenster, Germany.
9
Pediatric Hematopoietic Transplant Unit, Sant Pau Hospital, Barcelona, Spain.
10
Department of Pediatric Oncology and Hematology Hospital, Universitario Vall d'Hebron Barcelona, Spain.
11
Department of Pediatrics Stem Cell Transplantation Program, Leiden University Medical Center Leiden, Netherlands.
12
Department of Pediatrics, Jena University Hospital, Jena, Germany.
13
St Anna Children's Hospital, Medical University of Vienna.
14
Universitätsklinikum Leipzig, Department Pediatric Hematology, Oncology, Hemostaseology, Leipzig, Germany.
15
Clinic of Pediatric Hemato-Oncology, Department of Women's and Children's Health, University Hospital of Padova, Padova.
16
Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, Hôpital Hautepierre, Strasbourg, France.
17
Service of Pediatric Hematology-Oncology, Hôpital Armand Trousseau, Paris.
18
Unidad de Hematología y Oncología Pediátrica, Hospital Universitario La Paz, Madrid.
19
Instute Portugues Oncologia Lisboa, Lisboa, Portugal.
20
University Hospital Eppendorf Hamburg.
21
University Hospital Motol, Prague, Czech Republic.
22
Pediatric Blood and Marrow Transplantation Programm University Medical Center Utrechtand Laboratory for Translational Immunology Tumor-immunology, Utrecht, Netherlands.
23
Department for Children and Adolescents, Division for Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany.

Abstract

We report data obtained from a retrospective multicenter pediatric survey on behalf of the European Society for Blood and Marrow Transplantation (EBMT). Information on Solid Organ Transplantation (SOT) performed in pediatric recipients of either autologous or allogeneic hematopoietic stem cell transplantation (HSCT) between 1984 and 2016 were collected in 20 pediatric EBMT Centers (25.6%). Overall, we evaluated data on 44 SOTs following HSCT including 20 liver (LTx), 12 lung (LuTx), 6 heart (HTx), and 6 kidney (KTx) transplantations. The indication for SOT was organ failure related to intractable Graft-versus-Host Disease in 16 children (36.3%), acute or chronic HSCT-related toxicity in 18 (40.9%) and organ dysfunction related to the underlying disease in 10 (22.8%). The median follow-up was 10.9 years (95% CI: 1.7-29.5). The overall survival (OS) rate at 1 and 5 years after SOT was 85.7% and 80.4%, respectively: it was 74% and 63.2% after LTx, 83.2% after HTx, and 100% equally after LuTx and KTx. This multicenter survey confirms that SOT represents a promising option in children with severe organ failure occurred after HSCT. Additional studies are needed to further establish the effectiveness of SOT after HSCT and to better understand the mechanism underlying this encouraging success. This article is protected by copyright. All rights reserved.

PMID:
30586230
DOI:
10.1111/ajt.15240

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