Abstract：
Recent advances in the treatment of plasma cell disorders (PCDs) have provided a wealth of therapy alternatives and improved overall survival tremendously. Various types of PCDs are associated with kidney injury and end-stage kidney disease in a considerable number of patients. Kidney transplantation (KTx) is the best option for renal replacement therapy in select patients in terms of both quality of life parameters and overall survival. Even with modern therapies, all PCDs carry the risk of hematologic progression, whereas histologic recurrence and graft loss are other prevailing concerns in these patients. The risk of mortality is also higher in some of these disorders compared with KTx recipients who suffer from other causes of kidney disease. Unlike solid cancers, there is no well-defined \"waiting time\" after hematologic remission before proceeding to KTx. Thus, clinicians are usually reluctant to recommend KTx to patients who develop end-stage kidney disease due to PCDs. This review aims to provide the current evidence on KTx outcomes in patients with monoclonal gammopathy of renal significance and multiple myeloma. Although immunoglobulin light chain amyloidosis is a monoclonal gammopathy of renal significance subtype, KTx outcomes in this group are mentioned in another chapter of this issue.
摘要：
浆细胞疾病（PCD）治疗的最新进展提供了丰富的治疗替代方案，并极大地改善了总体生存率。在相当多的患者中,各种类型的PCDs与肾损伤和终末期肾病相关。就生活质量参数和总体生存率而言，肾移植（KTx）是选定患者肾脏替代治疗的最佳选择。即使使用现代疗法，所有PCDs都有血液学进展的风险，而组织学复发和移植物丢失是这些患者的其他主要问题。与患有其他肾脏疾病原因的KTx接受者相比，其中一些疾病的死亡风险也更高。与实体癌不同，在进行KTx之前，在血液学缓解后没有明确的“等待时间”。因此，临床医生通常不愿意向PCDs导致终末期肾病的患者推荐KTx.这篇综述旨在提供有关肾意义的单克隆丙种球蛋白病和多发性骨髓瘤患者KTx结局的最新证据。尽管免疫球蛋白轻链淀粉样变性是一种具有肾脏意义的单克隆丙种球蛋白病亚型，本组的KTx结果在本期的另一章中提到。
