| Title: |
Kidney Transplantation in Patients With AA Amyloidosis: Outcomes in a French Multicenter Cohort |
| Authors: |
Schwarz, C.; Georgin-Lavialle, S.; Lombardi, Y.; Marion, O.; Jambon, F.; Legendre, C.; Marx, D.; Levi, C.; Toure, F.; Le Quintrec, M.; Bobot, M.; Matignon, M.; Dujardin, A.; Maanaoui, Mehdi; Cuozzo, S.; Jalal-Eddine, A.; Louis, K.; Mohamadou, I.; Brazier, F.; De Nattes, T.; Geneste, C.; Thervet, E.; Ducloux, D.; Mayet, V.; Kormann, R.; Lanot, A.; Duveau, A.; Zaidan, M.; Mesnard, L.; Ouali, N.; Rondeau, E.; Petit-Hoang, C.; Audard, V.; Deshayes, A.; Moktefi, A.; Rabant, M.; Buob, D.; François, H.; Luque, Y. |
| Contributors: |
Université de Lille; Inserm; CHU Lille; Service de Néphrologie et Transplantation rénale CHRU-lille |
| Publisher Information: |
Elsevier |
| Publication Year: |
2024 |
| Collection: |
LillOA (Lille Open Archive - Université de Lille) |
| Subject Terms: |
AA amyloidosis; kidney transplantation; survival; Familial Mediterranean Fever (FMF); biotherapies; anti-IL-1 |
| Description: |
ationale & Objective Outcomes of kidney transplantation for patients with renal AA amyloidosis are uncertain, with reports of poor survival and high rates of disease recurrence. However, data are inconclusive and mostly based on studies from the early 2000s and earlier. Study Design Retrospective multicenter cohort study. Setting & Participants We searched the French national transplant database to identify all patients with renal AA amyloidosis who underwent kidney transplantation between 2008 and 2018. Exposures Age, cause of amyloidosis, use of biotherapies, CRP levels. Outcomes Outcomes were all-cause mortality and allograft loss. We also reported amyloidosis allograft recurrence, occurrence of acute rejection episodes, as well as infectious, cardiovascular, and neoplastic disease events. Analytical Approach The Kaplan-Meier estimator for mortality and the cumulative incidence function method for allograft loss. Factors associated with patient and allograft survival were investigated using a Cox proportional hazards model and a cause-specific hazards model, respectively. Results Eighty-six patients who received kidney transplants for AA amyloidosis at 26 French centers were included. The median age was 49.4 years (interquartile range 39.7-61.1). The main cause of amyloidosis was Familial Mediterranean Fever (37 cases, 43%). Sixteen (18.6%) patients received a biotherapy after transplantation. Patient survival was 94.0% (95% confidence interval 89.1-99.2) at 1 year and 85.5% (77.8-94.0) at 5 years post-transplantation. The cumulative incidence of allograft loss was 10.5% (4.0-17.0) at 1 year, and 13.0% (5.8-20.1) at 5 years post-transplantation. Histologically proven AA amyloidosis recurrence occurred in 5 transplants (5.8%). 55.8% of cases developed an infection requiring hospitalization and 27.9% acute allograft rejection. Multivariable analysis showed that CRP concentration at the time of transplantation was associated with patient survival (HR 1.01, 95% CI 1.00-1.02, p=0.01) and with allograft ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
37741608 |
| Relation: |
American Journal of Kidney Diseases; Am J Kidney Dis; http://hdl.handle.net/20.500.12210/103313 |
| Availability: |
https://hdl.handle.net/20.500.12210/103313 |
| Rights: |
info:eu-repo/semantics/closedAccess |
| Accession Number: |
edsbas.34B55B2B |
| Database: |
BASE |