Background Experience with sequential hematopoietic stem cell transplant (HSCT) and kidney transplant (KT) is limited. Methods We conducted a retrospective observational study of adult patients who underwent both HSCT and KT at our center, with a median follow-up of 11 years. Results In our 54 patients cohort (94% autologous HSCT), 36 (67%) patients received HSCT first followed by KT, while 18 (33%) received KT prior to HSCT. In both groups, AL amyloidosis represented 50% of hematologic diagnosis. Only 4 patients expired due to hematologic disease relapse (2 patients in each group) and only 3 allografts were lost due to hematologic disease recurrence (HSCT first n=1 and KT first n=2). Overall 1-year, 5 years and 10 years death-censored graft survival rates were 94%, 94%, and 94%, respectively for HSCT first group and 89%, 89%, and 75%, respectively for KT first group. Overall 1-year, 5 years and 10 years patients survival rates were 100%, 97% and 90%, respectively for HSCT first group and 100%, 76% and 63%, respectively for KT first group. Conclusions Our study supports safety of sequential KT and HSCT, with improved overall patient survival compared to recipients of HSCT remaining on dialysis and good long-term kidney allograft outcome.
