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Solid organ transplantation after hematopoietic stem cell transplantation in childhood: A multicentric retrospective survey

2018; Elsevier BV; Volume: 19; Issue: 6 Linguagem: Inglês

10.1111/ajt.15240

1600-6143

Maura Faraci, Alice Bertaina, Arnaud Dalissier, Marianne Ifversen, Ansgar Schulz, Andrew R. Gennery, Birgit Burkhardt, Isabel Badell, Cristina Díaz de Heredia, Edoardo Lanino, Arjan C. Lankester, Bernd Gruhn, Susanne Matthes‐Martin, Joern S. Kühl, Stefania Varotto, Catherine Paillard, Audrey Guilmatre, Ana Méndez‐Echevarría, Manuel Abecasis, Birgit Garwer, Petr Sedláček, Jaap Jan Boelens, Eric Beohou, Peter Bader,

Hematopoietic Stem Cell Transplantation

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 was 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-vs-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% confidence interval: 1.7-29.5). The overall survival 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 occurring 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.