[Kidney transplantation in a case of amyloidosis]

Renal transplantation was performed in five patients with various forms of amyloidosis (familial amyloidosis, Mediterranean fever and Crohn's disease). All grafts were functioning one year after the operation. Only one patient died of cardiac shock more than 10 years after transplantation; the other recipients are alive with a functioning graft from 12 to 67 (mean, 41) months after transplantation. No early severe infection was observed in any patient. Graft biopsy obtained in three patients disclosed amyloid deposits in only one: deposits initially (72 months post-transplantation) mild and perivascular, became more prominent in the vessels and extended into the mesangium 4 1/2 years later. Extrarenal amyloid involvement observed in four cases did not lead to serious clinical consequences during the follow-up period. Renal transplantation thus provides an effective treatment of terminal renal failure due to amyloidosis whatever its cause.