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Keywords:

  • Allograft rejection;
  • amyloidosis;
  • cardiac transplant;
  • lenalidomide;
  • renal transplant;
  • transplantation

Abstract

We describe a patient who underwent a successful heart and kidney transplant for light-chain amyloidosis. She had an excellent hematologic response to bortezomib/dexamethasone therapy. Follow-up therapy with lenalidomide was started, and the patient quickly had a fatal allograft rejection of the heart and kidney. We present evidence to support the theory that lenalidomide, a known immunomodulator, may have stimulated the immune system and precipitated the fatal rejection episode.