{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:15:23Z","timestamp":1760145323434,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2024,7,14]],"date-time":"2024-07-14T00:00:00Z","timestamp":1720915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The morbidity and mortality from AL amyloidosis has significantly improved with the development of novel treatments. Daratumumab is a highly effective treatment for AL amyloidosis, but end-stage kidney disease is a common complication of this condition. Kidney transplantation is the ideal form of renal replacement therapy but has historically been contraindicated in this group of patients. Methods: Given the improved survival and better treatments of both conditions, we argue that it is time to reconsider transplanting these patients. Results: We report our experience of transplanting four patients with AL amyloidosis who had achieved stable remission through treatment with daratumumab. Conclusions: We highlight the key challenges involved and discuss important clinical issues for patients receiving daratumumab, particularly the difficulties with interpreting the crossmatch in light of daratumumab and immunoglobulin therapy interference. We also discuss the complexities involved in balancing the risks of infection, relapse, rejection, and immunosuppression in such patients.<\/jats:p>","DOI":"10.3390\/jcm13144109","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T14:15:49Z","timestamp":1721052949000},"page":"4109","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Renal Transplant Outcomes in Plasma Cell Dyscrasias and AL Amyloidosis after Treatment with Daratumumab"],"prefix":"10.3390","volume":"13","author":[{"given":"Barian","family":"Mohidin","sequence":"first","affiliation":[{"name":"UCL Department of Renal Medicine, Royal Free Hospital, London NW3 2QG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Needleman","sequence":"additional","affiliation":[{"name":"UCL Department of Renal Medicine, Royal Free Hospital, London NW3 2QG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond","family":"Fernando","sequence":"additional","affiliation":[{"name":"H&I Laboratory, Royal Free Hospital, London NW3 2QG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6102-2375","authenticated-orcid":false,"given":"David M.","family":"Lowe","sequence":"additional","affiliation":[{"name":"UCL Institute of Immunity & Transplantation, Royal Free Hospital, London NW3 2QG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashutosh","family":"Wechalekar","sequence":"additional","affiliation":[{"name":"Department of Haematology, Royal Free Hospital, London NW3 2QG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Sheaff","sequence":"additional","affiliation":[{"name":"Department of Cellular Pathology, Royal London Hospital, London NW3 2QG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Salama","sequence":"additional","affiliation":[{"name":"UCL Department of Renal Medicine, Royal Free Hospital, London NW3 2QG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gareth","family":"Jones","sequence":"additional","affiliation":[{"name":"UCL Department of Renal Medicine, Royal Free Hospital, London NW3 2QG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1093\/ndt\/gfy291","article-title":"AL Amyloidosis: Advances in Diagnostics and Treatment","volume":"34","year":"2019","journal-title":"Nephrol. 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