Long-term outcome of live donor kidney transplantation for renal amyloidosis.

Abstract

BACKGROUND:

The short-term outcome of kidney transplantation in patients with amyloidosis has been reported. The aim of this study is to investigate long-term results in patients with renal amyloidosis.

METHODS:

We studied results of renal transplantation in 23 amyloidotic transplant recipients compared with those in a control group of 47 nonamyloidotic patients. Amyloidosis was secondary to familial Mediterranean fever (FMF) in 16 patients, whereas it was primary (idiopathic) in 7 transplant recipients. The 2 groups were homogeneous regarding age, sex, HLA matching, immunosuppression, and duration of transplantation.

RESULTS:

Five- and 10-year actuarial graft survival rates were similar in both groups (79.35% versus 84.04% and 65.92% versus 56.61%, respectively ). Five- and 10-year actuarial patient survival rates also were similar (80% versus 94% and 68% versus 87%, respectively). Moreover, 72.4% of controls experienced at least 1 rejection episode, whereas only 43.5% of amyloidotic transplant recipients experienced 1 or more such events (P = 0.02). Nonetheless, mean serum creatinine concentrations did not differ between the 2 groups during the observation period. Maintenance colchicine therapy prevented the recurrence of both FMF symptoms and amyloidosis. Recurrence was documented in only 1 amyloidotic transplant recipient (4.3%) 10 years posttransplantation. Significant gastrointestinal (GI) problems were more frequent in amyloidotic patients (65% versus 38%; P = 0.03). Amyloidotic patients with GI problems, except for 2 patients, were administered cyclosporine. Eleven of these patients had FMF, which appeared to reflect the effects of both cyclosporine and colchicine. Infections were similar in the groups; whereas amyloidotic patients had significantly lower blood pressures.

CONCLUSION:

In our experience, long-term (5 to 10 years) outcome of live related donor kidney transplantation in patients with amyloidosis is similar to that in the general transplant population.

• Authors: Ali Mohamed Sherif, Ayman Fathi Refaie, Mohamed Abdel-Kader Sobh, Nagi Abdel-Hadi Mohamed, Hussein Atia Sheashaa, Mohamed Ahmed Ghoneim
• Journal: American journal of kidney diseases : the official journal of the National Kidney Foundation (Am J Kidney Dis) Vol. 42 Issue 2 Pg. 370-5 (Aug 2003) ISSN: 1523-6838 [Electronic] United States
• PMID: 12900821 (Publication Type: Journal Article)

Chemical References

• Immunosuppressive Agents
• Cyclosporine

Topics

• Adolescent
• Adult
• Amyloidosis (drug therapy, etiology, surgery)
• Cyclosporine (therapeutic use)
• Familial Mediterranean Fever (complications, drug therapy)
• Female
• Follow-Up Studies
• Graft Rejection (epidemiology)
• Graft Survival
• Humans
• Hypertension (complications)
• Immunosuppressive Agents (therapeutic use)
• Kidney Failure, Chronic (drug therapy, etiology, surgery)
• Kidney Transplantation (statistics & numerical data)
• Life Tables
• Male
• Middle Aged
• Recurrence
• Treatment Outcome