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Kidney Transplant Outcomes in Amyloidosis: US National Database Study.
Junji Yamauchi1,2,3, Divya Raghavan1, Duha Jweehan1
1Department of Internal Medicine, Division of Nephrology & Hypertension, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT.
Transplantation
|August 28, 2024
Summary
Kidney transplant outcomes for amyloidosis patients show improvements over time. Survival rates after kidney transplantation for amyloidosis are comparable to diabetes, with some differences in living donor transplants.
Area of Science:
- Nephrology
- Transplantation Immunology
- Medical Statistics
Background:
- Amyloidosis treatment and prognosis have improved.
- Contemporary outcomes for kidney transplant recipients with amyloidosis require assessment.
Purpose of the Study:
- To evaluate changes in patient and graft survival for kidney transplant recipients with amyloidosis from 2002 to 2021.
- To compare transplant outcomes between amyloidosis and other kidney failure causes (diabetes, nondiabetes).
Main Methods:
- Utilized the US Organ Procurement and Transplantation Network database.
- Evaluated patient and graft survival trends (2002-2021).
- Performed 1:4 matched cohort analyses comparing amyloidosis vs. diabetes/nondiabetes for deceased donor kidney transplant (DDKT) and living donor kidney transplant (LDKT) (2012-2021).
Main Results:
- Identified 643 kidney recipients with amyloidosis (2002-2021).
- Patient and death-censored graft survival improved over time.
- No significant difference in patient survival between amyloidosis and diabetes groups for DDKT and LDKT.
- Amyloidosis DDKT patient survival was not significantly different from nondiabetes; however, LDKT patient survival was significantly lower (P=0.04).
- No significant difference in death-censored graft failure risk between amyloidosis and diabetes or nondiabetes groups for DDKT and LDKT.
Conclusions:
- Kidney transplant outcomes for amyloidosis patients are comparable to those with diabetes.
- Outcomes for amyloidosis patients are similar to nondiabetic kidney failure causes, except for lower patient survival in LDKT recipients.
- Improved amyloidosis management may contribute to stable long-term transplant outcomes.
