Outcome of Kidney Transplantation for Renal Amyloidosis:A Single-Center Experience

• Published in: Transplantation proceedings Vol. 38; no. 2; pp. 435 - 439
• Main Authors: Çelik, A., Saglam, F., Dolek, D., Sifil, A., Soylu, A., Cavdar, C., Temizkan, A., Bora, S., Gulay, H., Camsari, T.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2006; Elsevier Science
• Subjects: Actuarial Analysis; Acute Disease; Adolescent; Adult; Amyloidosis - etiology; Amyloidosis - mortality; Amyloidosis - surgery; Biological and medical sciences; Drug Therapy, Combination; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft Rejection - epidemiology; Graft Survival; Humans; Immunosuppressive Agents - therapeutic use; Kidney Diseases - mortality; Kidney Diseases - surgery; Male; Medical sciences; Middle Aged; Postoperative Complications - classification; Postoperative Complications - epidemiology; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Survival Analysis; Time Factors; Tissue, organ and graft immunology; Medicine; Center; Experience; Prognosis; Treatment; Urinary system; Surgery; Evolution; Graft; Homotransplantation; Kidney; Kidney transplantation
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2006.01.003

The aim of this retrospective study was to investigate the results of kidney transplantation in patients with renal amyloidosis. We analyzed the results of renal transplantation in 13 amyloidotic transplant recipients compared with those in a control group of 13 nonamyloidotic patients. While the etiology of amyloidosis was rheumatoid arthritis in one patient, in all of the others it was secondary to familial Mediterranean fever. Acute rejection episodes developed once in six and twice in one patient. The renal function in these patients was improved by antirejection treatment. Chronic rejection did not develop in any patient. However six patients (46%) died due to various complications despite functional grafts. The others are still being followed with well-functioning grafts. Among the control group, acute and chronic rejection were diagnosed in three and two patients, respectively: one patient returned to hemodialysis after 26 months of transplantation, while the others are still alive with functional grafts. There was no death in the control group. The 5- and 10-year actuarial patient survival rates of the amyloidosis and control groups were 52.2%, 26.6%, and 100%, 100%, respectively ( P = .002). However, the graft survivals of the amyloidosis versus control groups were 100%, 100%, versus 87.5%, 87.5, respectively ( P = .47). In conclusion, we observed a high rate of early mortality among recipients with amyloidosis associated with infectious complications. Moreover, patient survivals were lower among amyloidotic renal recipients.