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家族性地中海热和淀粉样变性患者肾移植的长期结果

Long-term Results of Kidney Transplantation in Patients With Familial Mediterranean Fever and Amyloidosis.

作者信息

Sarıtaş Hazen, Sendogan Damla Ors, Kumru Gizem, Sadioglu Rezzan Eren, Duman Neval, Erturk Sehsuvar, Nergisoglu Gokhan, Tuzuner Acar, Sengul Sule, Keven Kenan

机构信息

Department of Nephrology, Ankara University Medical School, Ankara, Turkey.

Department of Nephrology, Ankara University Medical School, Ankara, Turkey.

出版信息

Transplant Proc. 2019 Sep;51(7):2289-2291. doi: 10.1016/j.transproceed.2019.04.074. Epub 2019 Aug 7.

Abstract

INTRODUCTION

Amyloid A amyloidosis is most commonly caused by familial Mediterranean fever (FMF) in Turkey. Amyloidosis secondary to FMF is an important cause of end-stage renal failure, and kidney transplantation (KT) in these cases can be complicated, with long-term results oftentimes inferior compared with organ transplant in patients without FMF. The present study aims to show the long-term results of patients with secondary amyloidosis caused by FMF undergoing KT .

METHODS

We enrolled 27 patients with a history of FMF amyloidosis undergoing KT and a control group of 614 patients undergoing KT between 2005 and 2018 at Ankara University Medical School. All data were recorded retrospectively from patients files.

RESULTS

Twenty-two patients (81.5%) were treated with triple immunosuppressive therapy consisting of mycophenolate mofetil, tacrolimus, and a steroid; 5 patients (18.5%) were treated with tacrolimus, azathioprine, and prednisolone. Acute cellular rejection was seen in 3 patients (11.1%), and acute cellular- and antibody-mediated rejection occurred in 1 patient (3.7%). During the follow-up period, graft loss due to acute cellular rejection was observed in only 1 patient. One patient was lost to follow-up.

摘要

引言

在土耳其,淀粉样蛋白A淀粉样变性最常见的病因是家族性地中海热(FMF)。继发于FMF的淀粉样变性是终末期肾衰竭的重要原因,在这些病例中进行肾移植(KT)可能会很复杂,与没有FMF的患者进行器官移植相比,长期结果往往较差。本研究旨在展示因FMF导致继发性淀粉样变性的患者接受KT的长期结果。

方法

我们纳入了2005年至2018年期间在安卡拉大学医学院接受KT的27例有FMF淀粉样变性病史的患者以及614例接受KT的对照组患者。所有数据均从患者病历中回顾性记录。

结果

22例患者(81.5%)接受了由霉酚酸酯、他克莫司和一种类固醇组成的三联免疫抑制治疗;5例患者(18.5%)接受了他克莫司、硫唑嘌呤和泼尼松龙治疗。3例患者(11.1%)出现急性细胞排斥反应,1例患者(3.7%)出现急性细胞和抗体介导的排斥反应。在随访期间,仅1例患者因急性细胞排斥反应导致移植肾丢失。1例患者失访。

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