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Transplantation in renal amyloidosis
Clinical Transplantation
|October 27, 1998
Summary
Renal transplantation in patients with amyloidosis shows high risks, particularly cardiac complications. Preoperative cardiovascular assessment is crucial for improving outcomes in these high-risk kidney transplant recipients.
Area of Science:
- Nephrology
- Transplantation Immunology
- Cardiology
Background:
- Renal amyloidosis is a serious condition leading to end-stage renal failure.
- Kidney transplantation is a treatment option for end-stage renal failure.
- The outcomes of renal transplantation in patients with amyloidosis require further investigation.
Purpose of the Study:
- To analyze and compare the results of renal transplantation in patients with renal amyloidosis versus a control group.
- To identify complications and survival rates associated with renal transplantation in amyloidosis patients.
Main Methods:
- Retrospective analysis of 15 renal transplant recipients with amyloidosis and a control group.
- Follow-up period of 38.3 months.
- Comparison of graft survival, patient survival, and complication rates.
Main Results:
- Five patients with amyloidosis experienced complications, including death from cardiac amyloidosis, sepsis, cardiovascular failure, and hepatic failure.
- Acute and chronic rejection rates were observed in both groups, with improved renal function after anti-rejection therapies.
- The 5-year graft and patient survival rates were 75% and 77% for amyloidosis patients, compared to 95% and 100% for the control group.
Conclusions:
- Renal transplantation is not contraindicated for end-stage renal failure in amyloidosis patients but carries significant risks.
- Postoperative cardiac complications are a major concern.
- Mandatory preoperative cardiovascular evaluations are essential to improve prognosis by identifying and excluding high-risk individuals.