title: 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.
  
  
  CONCLUSIONS
  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.affiliation: Urology and Nephrology Center, Mansoura, Egypt.
authors.forename: Ali Mohamed
authors.initials: AM
authors.lastname: Sherif
authors.forename: Ayman Fathi
authors.initials: AF
authors.lastname: Refaie
authors.forename: Mohamed Abdel-Kader
authors.initials: MA
authors.lastname: Sobh
authors.forename: Nagi Abdel-Hadi
authors.initials: NA
authors.lastname: Mohamed
authors.forename: Hussein Atia
authors.initials: HA
authors.lastname: Sheashaa
authors.forename: Mohamed Ahmed
authors.initials: MA
authors.lastname: Ghoneim
mesh_terms: D000293:Adolescent; D000328:Adult; D000686:Amyloidosis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D016572:Cyclosporine / Q000627:therapeutic use; D010505:Familial Mediterranean Fever / Q000150:complications / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D006973:Hypertension / Q000150:complications; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine