Among therapy modalities of end-stage renal disease, renal transplantation improves survival in patients with amyloidosis.
The aim of this study was to investigate the results of renal transplantation in amyloidosis patients compared with those on hemodialysis. We compared a group of 25 patients with systemic amyloidosis and end-stage renal disease (ESRD) treated with renal transplantation with a control group of 30 patients with systemic amyloidosis and ESRD treated with hemodialysis. Overall 1-, 2-, and 5-year survival rates were 86.9%, 82.6%, and 78.2%, respectively, for patients, who had renal transplantations versus 60.7%, 50%, and 46.4%, respectively, for patients on hemodialysis treatments (P < .001). Among the control group 15 patients died at 9.4 +/- 7.5 months after starting hemodialysis. Among transplantation group five patients died during follow-up (mean 12.3 +/- 13.6 months); the major cause of death was infection. Only 18 patients experienced recurrences after renal transplantation; their 5-year survival rate was 84.2% versus 50% for patients who had no recurrence (P < .001). Patients with amyloid recurrence also had better long-term survival rates than patients in hemodialysis group (P < .001). In conclusion amyloidotic patients maintained on chronic dialysis have a high mortality rate. Better survival was noted for patients who had renal transplantations despite recurrences. These results encourage transplantation in amyloid renal end-stage disease.
Department of Pathology, Başkent University, Faculty of Medicine, Ankara, Turkey. handan27@hotmail.com
B H
BH
Ozdemir
F N
FN
Ozdemir
S
S
Sezer
A
A
Sar
M
M
Haberal
D000686:Amyloidosis / Q000150:complications / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology*; D012008:Recurrence; D006435:Renal Dialysis / Q000401:mortality; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey