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Study Supports Kidney Transplantation for AA Amyloidosis-Related Kidney Failure – Renal and Urology News

New study findings support kidney transplantation to treat kidney failure in patients with AA amyloidosis.

Using a French national transplant database, investigators studied 86 patients with renal AA amyloidosis who received a kidney transplant from 2008 to 2018 at 26 centers. Familial Mediterranean fever was the cause of amyloidosis in 37 cases (43%).

Patient survival was 94.0% at 1 year and 85.5% at 5 years after transplantation, a team led by Yosu Luque, MD, PhD, of Hôpital Tenon in Paris, France, reported in the American Journal of Kidney Diseases. The 5-year patient survival rate “is comparable to the outcomes of patients receiving a transplant for other forms of kidney diseases,” the authors wrote. Overall graft survival was 75.8% at 5 years, similar to national data.


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Histologically-confirmed AA amyloidosis recurred in 5.8% of transplanted kidneys after a median 23.5 months after transplantation. Infection requiring hospitalization developed in 55.8% of cases; acute rejection occurred in 27.9%.

Multivariable analysis showed that C-reactive protein level at the time of transplantation was significantly associated with patient and graft survival.

“To our knowledge, the present study is the largest cohort to report outcomes of kidney transplantation in patients with renal AA amyloidosis,” Dr Luque and colleagues wrote. “Our main findings are a high overall and graft survival and a low amyloidosis recurrence rate, suggesting that AA amyloidosis patients can benefit from kidney transplantation with favorable outcomes.”

With respect to study limitations, the investigators noted that they lacked a control group and the effect of biotherapies on transplant outcomes could not explored.

Reference

Schwarz C, Georgin-Lavialle S, Lombardi Y, et al. Kidney transplantation in patients with AA amyloidosis: outcomes in a French multicenter cohort. Am J Kidney Dis. Published online September 21, 2023. doi:10.1053/j.ajkd.2023.07.020