Haematological disorders following kidney transplantation

Nephrol Dial Transplant. 2022 Feb 25;37(3):409-420. doi: 10.1093/ndt/gfaa219.

Abstract

Transplantation offers cure for some haematological cancers, end-stage organ failure, but at the cost of long-term complications. Renal transplantation is the best-known kidney replacement therapy and it can prolong end-stage renal disease patient lives for decades. However, patients after renal transplantation are at a higher risk of developing different complications connected not only with surgical procedure but also with immunosuppressive treatment, chronic kidney disease progression and rejection processes. Various blood disorders can develop in post-transplant patients ranging from relatively benign anaemia through cytopenias to therapy-related myelodysplasia and acute myeloid leukaemia (AML) and post-transplant lymphoproliferative disorders followed by a rare and fatal condition of thrombotic microangiopathy and haemophagocytic syndrome. So far literature mainly focused on the post-transplant lymphoproliferative disease. In this review, a variety of haematological problems after transplantation ranging from rare disorders such as myelodysplasia and AML to relatively common conditions such as anaemia and iron deficiency are presented with up-to-date diagnosis and management.

Keywords: haematological complications; kidney transplantation; myelodysplasia; post-transplant lymphoproliferative disorder; thrombotic microangiopathy.

Publication types

  • Review

MeSH terms

  • Humans
  • Immunosuppressive Agents / adverse effects
  • Kidney Failure, Chronic* / complications
  • Kidney Failure, Chronic* / surgery
  • Kidney Transplantation* / adverse effects
  • Kidney Transplantation* / methods
  • Lymphoproliferative Disorders* / diagnosis
  • Lymphoproliferative Disorders* / etiology
  • Thrombotic Microangiopathies* / diagnosis
  • Thrombotic Microangiopathies* / etiology

Substances

  • Immunosuppressive Agents