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Renal transplantation in systemic amyloidosis
M Nishikido1, S Koga, H Kanetake
1Department of Urology, Nagasaki University School of Medicine, Japan.
Clinical Transplantation
|April 6, 2000
Summary
Renal transplantation successfully treated systemic amyloidosis in a young woman, with no amyloid recurrence 11 years post-op. The patient experienced improved systemic symptoms and satisfactory renal function, despite developing other kidney diseases.
Area of Science:
- Nephrology
- Transplantation Immunology
- Internal Medicine
Background:
- Systemic amyloidosis, particularly type AA, can lead to end-stage renal disease requiring renal replacement therapy.
- Renal transplantation is a potential therapeutic option for patients with systemic amyloidosis and kidney failure.
Observation:
- A 24-year-old woman with type AA systemic amyloidosis underwent renal transplantation.
- Eleven years post-transplantation, renal biopsy revealed no amyloid recurrence.
- The biopsy did show mesangial proliferative glomerulonephritis and focal segmental glomerulosclerosis.
Findings:
- Post-transplant renal function was satisfactory, with only mild proteinuria noted.
- Systemic symptoms of amyloidosis, including goiter and cardiac deposition, showed improvement.
- Despite the development of de novo glomerulonephritis, the graft remained functional and amyloid did not recur.
Implications:
- Renal transplantation is a viable and recommended treatment for type AA systemic amyloidosis, offering long-term graft survival and improvement in systemic manifestations.
- Monitoring for and managing potential de novo glomerular diseases post-transplantation is crucial for long-term outcomes.
- This case highlights the potential benefits of renal transplantation in managing systemic amyloidosis-related kidney failure.