Abstract Rationale Light chain disease (LCD) is a plasma cell disorder characterized by excess production of immunoglobulin light chains and is associated with a range of adverse outcomes, including thromboembolic events, skeletal complications, infections, and increased risk of malignancies such as multiple myeloma, lymphoma, and post-transplant lymphoproliferative disorder (PTLD). Although LCD has been described in other solid organ transplant populations, its impact on lung transplantation outcomes has not been previously evaluated. This study aims to characterize post-transplant complications in lung transplant recipients with LCD. Methods We conducted a retrospective review of all lung transplant recipients at a single high-volume center from January 2015 to December 2024. Patients with elevated immunoglobulin light chains were identified, and demographic data, baseline characteristics, and post-transplant malignant and non-malignant outcomes were collected and descriptively analyzed. Results Among 1,199 lung transplant recipients, 7.8% (n = 94) had elevated light chains. The most common pre-transplant diagnoses were idiopathic pulmonary fibrosis (42%, n = 39) and COPD (37%, n = 34). Single-lung transplantation occurred in 66% (n = 62). For Non-malignant complications, 44% (n = 41) experienced venous thrombotic events, 41% (n = 39) had osteoporosis, and 23% (n = 22) had osteopenia. Non-traumatic fractures occurred in 47% (n = 44). 41% (n = 39) developed de novo post-transplant malignancies, of which 64% (n = 25) were non-skin cancer-related. These included multiple myeloma (n = 1), PTLD (n = 3), and B-cell lymphoma (n = 2). Conclusion Light Chain Disease is relatively common among lung transplant recipients and is associated with a substantial burden of thromboembolic, skeletal, and malignant complications. These findings suggest the need for routine screening and vigilant post-transplant monitoring to identify patients at risk. Prospective studies are warranted to evaluate targeted surveillance and management strategies in this vulnerable cohort. This abstract is funded by: None
Halicki et al. (Fri,) studied this question.