title: Renal transplantation in patients with AA amyloidosis nephropathy: results from a French multicenter study.
abstract: Although end-stage renal disease related to AA amyloidosis nephropathy is well characterized, there are limited data concerning patient and graft outcome after renal transplantation. We performed a multicentric retrospective survey to assess the graft and patient survival in 59 renal recipients with AA amyloidosis. The recurrence rate of AA amyloidosis nephropathy was estimated at 14%. The overall, 5- and 10-year patient survival was significantly lower for the AA amyloidosis patients than for a control group of 177 renal transplant recipients (p = 0.0001, 0.028 and 0.013, respectively). In contrast, we did not observe any statistical differences in the 5- and 10- year graft survival censored for death between two groups. AA amyloidosis-transplanted patients exhibited a high proportion of infectious complications after transplantation (73.2%). Causes of death included both acute cardiovascular events and fatal septic complications. Multivariate analysis demonstrated that the recurrence of AA amyloidosis on the graft (adjusted OR = 14.4, p = 0.01) and older recipient age (adjusted OR for a 1-year increase = 1.06, p = 0.03) were significantly associated with risk of death. Finally, patients with AA amyloidosis nephropathy are eligible for renal transplantation but require careful management of both cardiovascular and infectious complications to reduce the high risk of mortality.
authors.affiliation: Service de Néphrologie et Transplantation, Hôpital Henri Mondor, AP-HP, Institut Francilien de recherche en Néphrologie et Transplantation (IFRNT), Paris Est Université Créteil, F-94010, France.
authors.forename: T
authors.initials: T
authors.lastname: Kofman
authors.forename: P
authors.initials: P
authors.lastname: Grimbert
authors.forename: F
authors.initials: F
authors.lastname: Canouï-Poitrine
authors.forename: J
authors.initials: J
authors.lastname: Zuber
authors.forename: V
authors.initials: V
authors.lastname: Garrigue
authors.forename: C
authors.initials: C
authors.lastname: Mousson
authors.forename: L
authors.initials: L
authors.lastname: Frimat
authors.forename: N
authors.initials: N
authors.lastname: Kamar
authors.forename: G
authors.initials: G
authors.lastname: Couvrat
authors.forename: N
authors.initials: N
authors.lastname: Bouvier
authors.forename: L
authors.initials: L
authors.lastname: Albano
authors.forename: A
authors.initials: A
authors.lastname: Le Thuaut
authors.forename: E
authors.initials: E
authors.lastname: Pillebout
authors.forename: G
authors.initials: G
authors.lastname: Choukroun
authors.forename: L
authors.initials: L
authors.lastname: Couzi
authors.forename: J
authors.initials: J
authors.lastname: Peltier
authors.forename: C
authors.initials: C
authors.lastname: Mariat
authors.forename: M
authors.initials: M
authors.lastname: Delahousse
authors.forename: M
authors.initials: M
authors.lastname: Buchler
authors.forename: P
authors.initials: P
authors.lastname: Le Pogamp
authors.forename: F
authors.initials: F
authors.lastname: Bridoux
authors.forename: C
authors.initials: C
authors.lastname: Pouteil-Noble
authors.forename: P
authors.initials: P
authors.lastname: Lang
authors.forename: V
authors.initials: V
authors.lastname: Audard
mesh_terms: D000328:Adult; D000686:Amyloidosis / Q000150:complications* / Q000601:surgery*; D002318:Cardiovascular Diseases / Q000209:etiology*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007239:Infections / Q000209:etiology / Q000401:mortality; D053208:Kaplan-Meier Estimate; D007674:Kidney Diseases / Q000401:mortality / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome