Kidney Transplantation in Systemic Amyloidosis

Area of Science:

• Nephrology
• Transplantation Immunology
• Internal Medicine

Background:

• Systemic amyloidosis significantly impairs kidney function, frequently causing end-stage renal disease.
• Advances in treating light-chain and amyloid A amyloidosis improve survival but often do not prevent renal failure.
• Inherited amyloidosis forms lack targeted treatments, sometimes making renal failure unavoidable.

Purpose of the Study:

• To review current developments and outcomes of renal transplantation in patients with systemic amyloidosis.
• To highlight the challenges in determining transplant eligibility and managing patients with amyloidosis.
• To emphasize the need for a multidisciplinary approach in renal transplantation for systemic amyloidosis.

Main Methods:

• Review of current literature on renal transplantation in systemic amyloidosis.
• Analysis of treatment outcomes and management strategies.
• Discussion of diagnostic and eligibility criteria.

Main Results:

• Increased survival in some amyloidosis types due to new treatments, but renal failure remains common.
• Growing number of patients with inherited amyloidosis facing unavoidable renal failure.
• Complex pathophysiology and treatment necessitate careful patient selection for transplantation.

Conclusions:

• Renal transplantation is a viable option for select systemic amyloidosis patients.
• Determining transplant eligibility and managing care requires a multidisciplinary team.
• Close peritransplant and posttransplant monitoring is crucial for successful outcomes.