Nowak Grzegorz, Suhr Ole B, Wikström Lars, Wilczek Henryk, Ericzon Bo-Göran
Department of Transplantation Surgery, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
Transpl Int. 2005 Jan;18(1):111-5. doi: 10.1111/j.1432-2277.2004.00015.x.
The aim of the study is to evaluate the long-term kidney function after liver transplantation (LTx) in familial amyloidotic polyneuropathy (FAP) Portuguese type patients and compare the findings with patients transplanted for chronic liver disease of other origin. We analysed the medical records of 32 FAP patients who underwent transplantation between 1990 and 1999 with a follow-up of more than 1 year after LTx. The control group consisted of 61 patients who had undergone LTx for chronic liver disease. Kidney function was measured by the glomerular filtration rate (GFR), serum creatinine and urea. There were no differences between the groups in creatinine and urea levels during the follow-up. However, during the first year after transplantation, the increase in creatinine and urea was significantly higher in the control group (P < 0.01). The decline in GFR after transplantation was also more pronounced in the controls (P < 0.01). Initially after LTx, kidney function deteriorated in both FAP and control patients, but the deterioration was more pronounced in the controls. The decline of the FAP patients' kidney function after LTx was not more pronounced than that observed in control patients, although many FAP patients' kidney function was impaired before the procedure, suggesting that LTx may halt the progression of kidney damage caused by amyloid deposition.
本研究的目的是评估葡萄牙型家族性淀粉样多神经病（FAP）患者肝移植（LTx）后的长期肾功能，并将结果与因其他原因慢性肝病接受移植的患者进行比较。我们分析了1990年至1999年间接受移植的32例FAP患者的病历，这些患者在肝移植后随访超过1年。对照组由61例因慢性肝病接受肝移植的患者组成。通过肾小球滤过率（GFR）、血清肌酐和尿素来测量肾功能。随访期间两组的肌酐和尿素水平无差异。然而，移植后的第一年，对照组的肌酐和尿素升高明显更高（P < 0.01）。移植后对照组的GFR下降也更明显（P < 0.01）。肝移植后最初，FAP患者和对照组患者的肾功能均恶化，但对照组更明显。尽管许多FAP患者在手术前肾功能已受损，但FAP患者肝移植后的肾功能下降并不比对照组更明显，这表明肝移植可能会阻止淀粉样蛋白沉积导致的肾损伤进展。
