Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Mini Review
  • Published:

Should we be performing more combined hematopoietic stem cell plus solid organ transplants?

Summary:

Both bone marrow and solid organ transplants (SOTs) can be life saving for a wide variety of diseases. We reviewed the literature and summarized the experiences of dual transplants. In total, 37 patients received a SOT for organ failure after a previous hematopoietic stem cell transplant. In all, 12 subjects received SOTs followed by a bone marrow transplant, while three patients received simultaneous SOTs and bone marrow transplants. Of these 52 patients, 37 were alive at the time of the original report at follow-up times ranging from 3 months to 8 years. A special registry for data collection may prove helpful for obtaining long-term follow-up data and providing outcome information that may improve future patient survival.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. 2001 OPTN/SRTR Annual Report 1991–2000. HHS/HRSA/OSP/DOP; UNOS; URREA. 2001 Annual Report of the U.S. Organ Procurement and Transplantation Network and the Scientific Registry for Transplant Recipients: Transplant Data 1991–2000. Department of Health and Human Services: Rockville, MD; United Network for Organ Sharing, Richmond, VA; University Renal Research and Education Association: Ann Arbor, MI.

  2. Gruessner RW, Zhang KY, Dunning M et al. Bone marrow augmentation in kidney transplantation: a large animal study. Transplant Int 2001; 14: 159–169.

    Article  CAS  Google Scholar 

  3. Ciancio G, Miller J, Garcia-Morales RO et al. Six-year clinical effect of donor bone marrow infusions in renal transplant patients. Transplantation 2001; 71: 827–835.

    Article  CAS  Google Scholar 

  4. Pham SM, Rao AS, Zeevi A et al. Effects of donor bone marrow infusion in clinical lung transplantation. Ann Thorac Surg 2000; 69: 345–350.

    Article  CAS  Google Scholar 

  5. Pham SM, Rao AS, Zeevi A et al. A clinical trial combining donor bone marrow infusion and heart transplantation: intermediate-term results. J Thorac Cardiovasc Surg 2000; 119: 673–681.

    Article  CAS  Google Scholar 

  6. Corry RJ, Chakrabarti PK, Shapiro R et al. Simultaneous administration of adjuvant donor bone marrow in pancreas transplant recipients. Ann Surg 1999; 230: 372–379.

    Article  CAS  Google Scholar 

  7. Dey B, Sykes M and Spitzer TR . Outcomes of recipients of both bone marrow and solid organ transplants. Medicine 1998; 77: 355–369.

    Article  CAS  Google Scholar 

  8. Cruz DN, Perazella MA, Mahnensmith RL . Bone marrow transplant nephropathy: a case report and review of the literature. J Am Soc Nephrol 1997; 8: 166–173.

    CAS  PubMed  Google Scholar 

  9. Kist-van Holthe JE, van Zwet JML, Brand R et al. Bone marrow transplantation in children: consequences for renal function shortly after and 1 year post-BMT. Bone Marrow Transplant 1998; 22: 559–564.

    Article  CAS  Google Scholar 

  10. Gruss E, Bernis C, Tomas J et al. Acute renal failure in patients following bone marrow transplantation: pre-valence, risk factors and outcome. Am J Nephrol 1995; 15: 473–479.

    Article  CAS  Google Scholar 

  11. Lane PH, Mauer SM, Blazar BR et al. Outcome of dialysis for acute renal failure in pediatric bone marrow transplant patients. Bone Marrow Transplant 1994; 13: 613–617.

    CAS  Google Scholar 

  12. Sayegh MH, Fine NA, Smith JL et al. Immunologic tolerance to renal allografts after bone marrow transplants from same donors. Ann Intern Med 1991; 114: 954–955.

    Article  CAS  Google Scholar 

  13. Jacobsen N, Taaning E, Ladefoged J et al. Tolerance to an HLA-B, DR disparate kidney allograft after bone-marrow transplantation from same donor. Lancet 1994; 343: 800.

    Article  CAS  Google Scholar 

  14. Helg C, Chapuis B, Bolle JF et al. Renal transplantation without immunosuppression in a host with tolerance induced by allogeneic bone marrow transplantation. Transplantation 1994; 58: 1420–1422.

    CAS  PubMed  Google Scholar 

  15. Sorof JM, Koerper MA, Portale AA et al. Renal transplant-ation without chronic immunosuppression after T cell-depleted, HLA-mismatched bone marrow transplantation. Transplantation 1995; 59: 1633–1635.

    CAS  PubMed  Google Scholar 

  16. Butcher JA, Hariharan S, Adams MB et al. Renal transplantation for end-stage renal disease following bone marrow transplantation: a report of six cases, with and without immunosuppression. Clin Transplant 1999; 13: 330–335.

    Article  CAS  Google Scholar 

  17. Seller MT, Deierhoi MH, Curtis JJ et al. Tolerance in renal transplantation after allogeneic bone marrow transplantation-6-year follow-up. Transplantation 2001; 71: 1681–1683.

    Article  Google Scholar 

  18. Miano M, Ginevri F, Nocera A et al. Successful double bone marrow and renal transplantation in a patient with Fanconi anemia. Blood 2002; 99: 3482–3483.

    Article  CAS  Google Scholar 

  19. Bearman SI . The syndrome of hepatic veno-occlusive disease after marrow transplantation. Blood 1995; 85: 3005–3020.

    CAS  Google Scholar 

  20. Nimer SD, Milewicz AL, Champlin RE et al. Successful treatment of hepatic venoocclusive disease in a bone marrow transplant patient with orthotopic liver transplantation. Transplantation 1990; 49: 819–821.

    Article  CAS  Google Scholar 

  21. Rhodes DF, Lee WM, Wingard JR et al. Orthotopic liver transplantation for graft-versus-host disease following bone marrow transplantation. Gastroenterology 1990; 99: 536–538.

    Article  CAS  Google Scholar 

  22. Rapoport AP, Doyle HR, Starzl T et al. Orthotopic liver transplantation for life-threatening veno-occlusive disease of the liver after allogeneic bone marrow transplant. Bone Marrow Transplant 1991; 8: 421–424.

    CAS  Google Scholar 

  23. Marks DI, Dousset B, Robson A et al. Orthotopic liver transplantation for hepatic GVHD following allogeneic BMT for chronic myeloid leukaemia. Bone Marrow Transplant 1992; 10: 463–466.

    CAS  PubMed  Google Scholar 

  24. Schlitt HJ, Tischler HJ, Ringe B et al. Allogeneic liver transplantation for hepatic veno-occlusive disease after bone marrow transplantation – clinical and immunological consideration. Bone Marrow Transplant 1995; 16: 473–478.

    CAS  Google Scholar 

  25. Dowlati A, Honore P, Damas . Hepatic rejection after orthotopic liver transplantation for hepatic VOD or GNHD following BMT. Transplantation 1995; 60: 106–109.

    Article  CAS  Google Scholar 

  26. Bunin N, Leahey A, Dunn S . Related donor liver transplant for veno-occlusive disease following T-depleted unrelated donor bone marrow transplantation. Transplantation 1996; 61: 664–666.

    Article  CAS  Google Scholar 

  27. Rosen HR, Martin P, Schiller GJ et al. Orthotopic liver transplantation for bone-marrow transplant-related veno-occlusive disease and graft-versus-host disease of the liver. Liver Transplant Surg 1996; 2: 225–232.

    Article  CAS  Google Scholar 

  28. Figuera A, Tomas JF, Otero MJ et al. Orthotopic liver transplantation for acute grade IV hepatic graft-versus-host disease following bone marrow transplantation. Am J Hematol 1996; 52: 68–69.

    Article  CAS  Google Scholar 

  29. Salat C, Holler E, Wolf C et al. Laboratory markers of veno-occlusive disease in the course of bone marrow and subsequent liver transplantation. Bone Marrow Transplant 1997; 19: 487–490.

    Article  CAS  Google Scholar 

  30. Norris S, Crosbie O, McEntee G et al. Orthotopic liver transplantation for veno-occlusive disease complicating autologous bone marrow transplantation. Transplantation 1997; 63: 1521–1524.

    Article  CAS  Google Scholar 

  31. Winer-Muram HT, Gurney JW, Bozeman PM et al. Pulmonary complications after bone marrow transplantation. Radiol Clin North Am 1996; 34: 97–118.

    CAS  Google Scholar 

  32. Calhoon JH, Levine S, Anzueto A et al. Lung transplantation in a patient with a prior bone marrow transplant. Chest 1992; 102: 948.

    Article  CAS  Google Scholar 

  33. Gascoigne A, Corris P . Lung transplants in patients with prior bone marrow transplants. Chest 1994; 105: 327.

    Article  CAS  Google Scholar 

  34. Svendsen UG, Aggestrup S, Heilmann C et al. Transplantation of a lobe of lung from mother to child following previous transplantation with maternal bone marrow. J Heart Lung Transplant 1999; 18: 388–390.

    Article  CAS  Google Scholar 

  35. Rabitsch W, Deviatko E, Keil F et al. Successful lung transplantation for bronchiolotis obliterans after allogeneic marrow transplantation. Transplantation 2001; 71: 1341–1343.

    Article  CAS  Google Scholar 

  36. Heath JA, Kurland G, Spray TL et al. Lung transplantation after allogeneic marrow transplantation in pediatric patients: the Memorial Sloan-Kettering experience. Transplantation 2001; 72: 1986–1990.

    Article  CAS  Google Scholar 

  37. Ramrakha PS, Marks DI, O'Brien SG, Yacoub M, Schofield JB, Goldman JM . Orthotopic cardiac transplantation for dilated cardiomyopathy after allogeneic bone marrow transplantation. Clin Transplant 1994; 8: 23–26.

    CAS  PubMed  Google Scholar 

  38. Baronciani D, Angelucci E, Mariotti E et al. Sudden cardiac tamponade in thalassemia after chemotherapy for BMT. Bone Marrow Transplant 1993; 12 (Suppl 1): 91–92.

    PubMed  Google Scholar 

  39. Steinherz LJ, Graham T, Hurwitz R et al. Guidelines for cardiac monitoring of children during and after anthracycline therapy: report of the Cardiology Committee of the Children Cancer Study Group. Pediatrics 1992; 89: 942–949.

    CAS  PubMed  Google Scholar 

  40. Steinherz LJ, Steinherz PG, Mangiacasale D et al. Cardiac changes with cyclophosphamide. Med Pediatr Oncol 1981; 9: 417–422.

    Article  CAS  Google Scholar 

  41. Hertenstein B, Stefanic M, Schmeiser T et al. Cardiac toxicity of bone marrow transplantation: predictive value of cardio-logic evaluation before transplant. J Clin Oncol 1994; 12: 998–1004.

    Article  CAS  Google Scholar 

  42. Eames GM, Crosson J, Steinberger J et al. Cardiovascular function in children following bone marrow transplant: a cross-sectional study. Bone Marrow Transplant 1997; 19: 61–66.

    Article  CAS  Google Scholar 

  43. Hagler L, Pastore RA, Bergin JJ . Aplastic anemia following viral hepatitis: report of two fatal cases and literature review. Medicine 1975; 54: 139–164.

    Article  CAS  Google Scholar 

  44. IBMTR/ABMTR Summary slides, 2002.

  45. Bismuth H, Samuel D, Gugenheim J et al. Emergency liver transplantation for fulminant hepatitis. Ann Intern Med 1987; 107: 337–341.

    Article  CAS  Google Scholar 

  46. Tzakis AG, Arditi M, Whitington PF et al. Aplastic anemia complicating orthotopic liver transplantation for non-A, non-B hepatitis. New Engl J Med 1988; 319: 393–396.

    Article  CAS  Google Scholar 

  47. Itterbeek P, Vandenberghe P, Nevens F et al. Aplastic anemia after transplantation for non-A, non-B, non-C fulminant hepatic failure: case report and review of the literature. Transplant Int 2002; 15: 117–123.

    Google Scholar 

  48. Kawahara K, Storb R, Sanders J et al. Successful allogeneic bone marrow transplantation in a 6.5 year-old male for severe aplastic anemia complicating orthotopic liver transplantation for fulminant non-A-non-B hepatitis. Blood 1991; 78: 1140–1143.

    CAS  Google Scholar 

  49. Dugan MJ, Rouch DA, Akard LP et al. Successful allogeneic bone marrow transplantation in an adult with aplastic anemia following orthotopic liver transplantation for non-A, non-B, non-C hepatitis. Bone Marrow Transplant 1993; 12: 417–419.

    CAS  Google Scholar 

  50. Trede NS, Warwick AB, Rosoff PM et al. Tacrolimus (FK506) in allogeneic bone marrow transplantation for severe aplastic anemia following orthotopic liver transplantation. Bone Marrow Transplant 1997; 20: 257–260.

    Article  CAS  Google Scholar 

  51. Hägglund H, Winiarski J, Ringden O et al. Successful allogeneic bone marrow transplantation in a 2.5-year-old boy with ongoing cytomegalovirus viremia and severe aplastic anemia after orthotopic liver transplantation for non-A, non-B, non-C hepatitis. Transplantation 1997; 64: 1207–1208.

    PubMed  Google Scholar 

  52. Bühler L, Mentha G, Giostra E et al. Autologous bone marrow transplantation for recurrent malignant lymphoma after liver transplantation. Transplantation 1999; 67: 630–631.

    Article  Google Scholar 

  53. Matthes-Martin S, Peters C, Konigsrainer A et al. Successful stem cell transplantation following orthotopic liver transplantation from the same haploidentical family donor in a girl with hemophagocytic lymphohistiocytosis. Blood 2000; 96: 3997–3999.

    CAS  PubMed  Google Scholar 

  54. Perkins JL, Neglia JP, Ramsay NK et al. Successful bone marrow transplantation for severe aplastic anemia following orthotopic liver transplantation: long-term follow-up and outcome. Bone Marrow Transplant 2001; 28: 523–526.

    Article  CAS  Google Scholar 

  55. Spitzer TR, Zwiebel J, Jacobson RJ . Transplants from the same donor. Ann Intern Med 1991; 115: 498.

    Article  CAS  Google Scholar 

  56. Vesole DH, Jagannath S . Transplants from the same donor. Ann Intern Med 1992; 116: 269–270.

    Article  CAS  Google Scholar 

  57. Mahe B, Moreau P, Le Tortorec S et al. Harousseau JL, Milpied N . Autologous bone marrow transplantation for cyclosporin-related lymphoma in a renal transplant patient. Bone Marrow Transplant 1994; 14: 645–646.

    CAS  PubMed  Google Scholar 

  58. Weekly clinicopathological exercises. Case records (Case 19–1996) of the Massachusetts General Hospital. N Engl J Med 1996; 334: 1655–1662.

  59. Lister J, Simpson JK, deMagalhaes-Silverman MM et al. Allogeneic peripheral blood stem cell transplant for myelodysplasia after chemotherapy for post-transplant lymphoma in a cardiac transplant recipient at 10 years. Bone Marrow Transplant 1997; 19: 943–945

    Article  CAS  Google Scholar 

  60. Huber C, Niederwieser D, Schonitzer D et al Margreiter R . Liver transplantation followed by high-dose cyclophosphamide, total-body irradiation, and autologous bone marrow transplantation for treatment of metastatic breast cancer. A case report. Transplantation 1984; 37: 311–312.

    Article  CAS  Google Scholar 

  61. Spitzer TR, Delmonico F, Tolkoff-Rubin N et al. Combined histocompatibility leukocyte antigen matched donor bone marrow and renal transplantation for multiple myeloma with end stage renal disease: the induction of allograft tolerance through mixed lymphohematopoietic chimerism. Transplant-ation 1999; 68: 480–484.

    Article  CAS  Google Scholar 

  62. Hadžić N, Pagliuca A, Rela M et al. Correction of the hyper-IgM syndrome after liver and bone marrow transplantation. N Engl J Med 2000; 342: 320–324.

    Article  Google Scholar 

  63. Urban Ch, Deutschmann A, Kerbl R et al. Organ tolerance following cadaveric liver transplantation for chronic graft-versus-host-disease after allogeneic bone marrow transplantation. Bone Marrow Transplant 2002; 30: 535–537.

    Article  CAS  Google Scholar 

  64. Umeda K, Adachi S, Watanabe K et al. Successful hematopoietic stem cell transplantation for aplastic anemia following living-related liver transplantation. Bone Marrow Transplant 2002; 30: 531–534.

    Article  CAS  Google Scholar 

  65. Buhler LH, Spitzer TR, Sykes M et al. Induction of kidney allograft tolerance after transient lymphohematopoietic chimerism in patients with multiple myeloma and end-stage renal disease. Transplantation 2002; 74 (10): 1405–1409.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Addendum: Since the completion of this manuscript, there have been three additional reports63,64,65 of patients receiving both bone marrow and solid organ transplants, one in each category mentioned in this analysis. We may be seeing more growth in this exciting field.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chiang, K., Lazarus, H. Should we be performing more combined hematopoietic stem cell plus solid organ transplants?. Bone Marrow Transplant 31, 633–642 (2003). https://doi.org/10.1038/sj.bmt.1703952

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1703952

Keywords

This article is cited by

Search

Quick links