title: Infections After Renal Transplant in Recipients With Familial Mediterranean Fever: A Life-Threatening Issue.
abstract: OBJECTIVE
  We evaluated long-term results and infections requiring hospitalization in kidney transplant patients with Familial Mediterranean Fever (associated amyloidosis-type).
  
  
  METHODS
  We retrospectively reviewed medical records of patients with familial Mediterranean fever with at least 1-year posttransplant follow-up. Kidney transplant recipients with primary glomerulonephritis and equivalent demography, immunity status, and follow-up comprised the control group.
  
  
  RESULTS
  In 32 patients with familial Mediterranean fever versus 25 control patients (mean follow-up 82 ± 57 vs 79 ± 54 mo; P = .82), average serum creatinine values were 1.7 ± 0.9 versus 1.5 ± 1.0 mg/dL (P = .41) at discharge, 1.4 ± 0.4 versus 1.3 ± 0.5 mg/dL (P = .44) at 1 year, 1.4 ± 0.6 versus 1.3 ± 0.5 mg/dL (P = .63) at 3 years, and 2.0 ± 1.5 versus 2.1 ± 1.5 mg/dL (P = .92) at last follow-up. Groups were not statistically different regarding average inpatient and number of hospitalizations due to infections at 1 year; however, at last follow-up, 26 patients with familial Mediterranean fever (81%) had 8.6 average admissions and 13 control patients (52%) had 2.8 average admissions (P = .02, P < .01). Early posttransplant, both groups were taking a triple drug immunosuppression regimen. However, at 1 and 3 years posttransplant, withdrawal and/or minimization occurred in 40.6% and 83.3% of patients with familial Mediterranean fever and 28% and 55.5% of control patients (P < .05, P < .05). During follow-up, 6 familial Mediterranean fever patients (18.7%) and 2 control patients (8%) died (P = .23).
  
  
  CONCLUSIONS
  Although renal transplant patients with associated amyloidosis-type familial Mediterranean fever and those with glomerulonephritis have similar rejection and/or graft loss rates, hospital admissions due to infection and increased mortality are more common in the familial Mediterranean fever group, with immunosuppression drug withdrawal.
authors.affiliation: Department of Nephrology, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey.
authors.forename: Erhan
authors.initials: E
authors.lastname: Tatar
authors.forename: Murat
authors.initials: M
authors.lastname: Karatas
authors.forename: Ahmet
authors.initials: A
authors.lastname: Aykas
authors.forename: Gokalp
authors.initials: G
authors.lastname: Okut
authors.forename: Giray
authors.initials: G
authors.lastname: Bozkaya
authors.forename: Adam
authors.initials: A
authors.lastname: Uslu
mesh_terms: D000328:Adult; D003141:Communicable Diseases / Q000209:etiology* / Q000276:immunology / Q000401:mortality / Q000628:therapy; D057915:Drug Substitution; D010505:Familial Mediterranean Fever / Q000150:complications* / Q000276:immunology / Q000401:mortality; D005260:Female; D006760:Hospitalization; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D051437:Renal Insufficiency / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents