Amyloidosis Diagnosed in Solid Organ Transplant Recipients
| Autor: | Carol J. Whelan, Dorota Rowczenio, Marianna Fontana, Richa Manwani, Ana Martinez-Naharro, Helen J. Lachmann, Julian D. Gillmore, Sajitha Sachchithanantham, Shameem Mahmood, Tamer Rezk, Faye Sharpley, Philip N. Hawkins, Ashutosh D. Wechalekar, Janet A. Gilbertson, Cristina Quarta |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Time Factors Adolescent Amyloid 030230 surgery Gastroenterology Organ transplantation Young Adult 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Humans Serum amyloid A Child Aged Transplantation Lung biology business.industry Incidence Amyloidosis Organ Transplantation Middle Aged Plasma cell neoplasm medicine.disease Transplant Recipients United Kingdom Survival Rate Transthyretin medicine.anatomical_structure biology.protein Female 030211 gastroenterology & hepatology business Follow-Up Studies |
| Zdroj: | Transplantation. 104:415-420 |
| ISSN: | 0041-1337 |
| Popis: | Background Development of amyloidosis post solid-organ transplantation has not been reported, although plasma cell neoplasms are a rare form of posttransplant lymphoproliferative disorder, which could be complicated by light chain amyloidosis (AL) amyloidosis. Methods We searched our database of 5112 patients seen between 1994 and 2018 with a diagnosis of amyloidosis post solid-organ transplant. Patients were excluded if the amyloid diagnosis preceded the transplant date. The indication and type of organ transplant were recorded in addition to the amyloidosis type, organs involved, treatment given, and survival. Results Thirty patients were identified. The median age at diagnosis with amyloidosis was 52 years (range 33-77). The median time from transplantation to diagnosis was 10.5 years (0.58-36). The grafts were kidney (N = 25, 83.3%), liver (N = 2, 6.7%), heart (N = 2, 6.7%), and combined heart, lung, and kidney (N = 1, 3.3%). The type of amyloidosis was systemic AL (N = 14, 47%), serum amyloid A amyloidosis (AA) (N = 11, 37%), localized AL (N = 3, 10%), wild-type transthyretin amyloidosis (ATTR) (N = 1, 3.3%), and amyloid of uncertain type (N = 1, 3.3%). Renal graft dysfunction was seen in 11 of 25 (44%) cases. Median graft survival was 185 months (96-269), and median survival from diagnosis with amyloidosis was 45 months (2-89); median survival by amyloidosis type was localized AL: 64 months (20-67), systemic AL: 23.5 months (0-95), ATTR amyloidosis: 17 months, and AA, 15 months (0-77). Conclusions This series is the first description of amyloidosis post solid-organ transplant; 30 cases among 5112 amyloid patients >24 years suggests that amyloidosis may occur post solid-organ transplantation with an overall poor survival. |
| Databáze: | OpenAIRE |
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