Renal transplant outcomes in amyloidosis

Abstract Background Outcomes after renal transplantation have traditionally been poor in systemic amyloid A (AA) amyloidosis and light chain (AL) amyloidosis, with high mortality frequent recurrent disease. We sought to compare outcomes matched transplant recipients autosomal dominant polycystic kidney disease (ADPKD) diabetic nephropathy (DN), identify factors predictive of outcomes. Methods performed a retrospective cohort study 51 AL 48 AA patients undergoing transplantation. Matched groups were generated by propensity score matching. Patient death-censored allograft survival compared via Kaplan–Meier analyses, assessment clinicopathological features predicting Cox proportional hazard analyses. Results One-, 5- 10-year unadjusted graft was, respectively, 94, 91 78% for 98, 93 93% amyloidosis; median patient was 13.1 7.9 years, respectively. comparable DN, but poorer than ADPKD [hazard ratio (HR) = 3.12 3.09, respectively; P < 0.001]. Death-censored between all groups. In predicted interventricular septum at end diastole (IVSd) thickness >12 mm (HR 26.58; 0.03), while haematologic response (very good partial or complete response; HR 0.07; 0.018). associated elevated serum concentration not Conclusions Renal selected are those DN. IVSd achievement deep pre-transplant profoundly impact survival.