Gursu Meltem, Yelken Berna, Caliskan Yasar, Kazancioglu Rumeyza, Yazici Halil, Kilicaslan Isin, Turkmen Aydin, Sever Mehmet S
Department of Nephrology, Haseki Training and Research Hospital, Istanbul - Turkey.
Int J Artif Organs. 2012 Jun;35(6):444-9. doi: 10.5301/ijao.5000091.
The prognostic outcome of patients with amyloidosis who receive a kidney transplant is controversial. The aim of the study was to analyze the renal transplantation outcome of patients with amyloidosis compared to transplant recipients with other kidney diseases.
Among 940 patients who had renal transplantation in our unit between 1983 and 2009, 44 patients with amyloidosis were compared regarding early and late complications and survival, retrospectively, with a control group of 41 consecutive patients with the same donor type and a matched renal transplantation date.
The groups were similar regarding demographic parameters, HLA mismatch numbers and mean follow-up period. Groups were similar regarding early and late infectious and non-infectious complications, except recurrence of the primary disease, which was more common in the amyloidosis group. As the cause of graft loss, rejection (acute or chronic) was more common in the control group; whereas primary non-functioning graft, and death with a functioning graft were more common in the amyloidosis group. Patient survival rates at 1, 5, and 10 years were 87.6%, 78.1%, and 62.3 in the amyloidosis group; and 93.2%, 82.6%, and 69.3% in the control group. Graft survival rates at 1, 5 and 10 years were 87.6%, 75.4%, 56.4% in the amyloidosis group; and 93.2%, 80.3%, and 60.6% in the control group, respectively. These values did not show any statistical difference.
The outcomes of renal transplantation in patients with amyloidosis are comparable with recipients whose primary problems are due to other kidney diseases; therefore, amyloidosis patients should be accepted as good candidates for transplantation.
接受肾移植的淀粉样变性患者的预后结果存在争议。本研究的目的是分析淀粉样变性患者与患有其他肾脏疾病的移植受者相比的肾移植结果。
在1983年至2009年间于本单位接受肾移植的940例患者中，回顾性比较了44例淀粉样变性患者与41例连续的具有相同供体类型且肾移植日期匹配的对照组患者的早期和晚期并发症及生存率。
两组在人口统计学参数、HLA错配数和平均随访期方面相似。除原发性疾病复发在淀粉样变性组更常见外，两组在早期和晚期感染性及非感染性并发症方面相似。作为移植物丢失的原因，排斥反应（急性或慢性）在对照组更常见；而原发性无功能移植物和有功能移植物的死亡在淀粉样变性组更常见。淀粉样变性组1年、5年和10年的患者生存率分别为87.6%、78.1%和62.3%；对照组分别为93.2%、82.6%和69.3%。淀粉样变性组1年、5年和10年的移植物生存率分别为87.6%、75.4%和56.4%；对照组分别为93.2%、80.3%和60.6%。这些值未显示出任何统计学差异。
淀粉样变性患者的肾移植结果与原发性问题由其他肾脏疾病引起的受者相当；因此，淀粉样变性患者应被视为移植的良好候选者。
