Abstract
Renal transplantation was performed in 2 patients with end-stage renal disease due to AA-type amyloidosis. One patient with amyloidosis of rheumatoid arthritis (RA) origin died twelve months after renal transplantation in cardiogenic shock. AA-amyloid deposits were demonstrated in the graft even though there were excellent function and no proteinuria. The second patient with amyloid nephropathy due to familial Mediterranean fever (FMF) showed no impairment of graft function 24 months after transplantation. These 2 cases are compared to an additional 31 cases of renal transplantation for amyloid nephropathy described in the literature. Proteinuria was reported in 32.3% and amyloid was detected in the functioning graft in 41.4%. The function was excellent even when small amyloid deposits were present in the graft. Renal transplantation is indicated in cases of amyloid nephropathy of the AA-type, provided life threatening amyloid involvement of other organs is not present.
Similar content being viewed by others
References
Advisory Committee to The Renal Transplant Registry: Renal transplantation in congenital and metabolic diseases. A report from the ACS/NIH Renal Transplant Registry.J. Am. Med. Assoc., 232, 148 (1975).
Banks, R. A., Tribe, C. R., White, H. J. O., Harrison, P. R., Mackenzie, J. C.: Replacement therapy in end-stage renal amyloidosis.J. R. Soc. Med., 78, 593 (1985).
Bohle, A., Fischbach, H., Gärtner, H. V., Helmchen, U., Patjan, K., Wildhirt, E.: Simultaneous occurrence of perimembranous glomerulonephritis and glomerular amyloidosis.Virchows Arch. [A],378, 315 (1978).
Belzer, F., Ashby, B., Gulyassy, P., Powell, M.: Successful seventeen-hour preservation and transplantation of human-cadaver kidney.N. Engl. J. Med., 278, 608 (1968).
Benson, M. C., Skinner, M., Cohen, A. S.: Amyloid deposition in a renal transplant in familial Mediterranean fever.Ann. Int. Med., 87, 31 (1977).
Browning, M., Banks, R. A., Harrison, P., Tribe, C. R., Fraley, C. T., Zachary, G., Mackenzie, C.: CAPD in systemic amyloidosis and end stage renal disease.J. R. Soc. Med., 77, 189 (1984).
Cohen, A. S., Bricetti, A., Harrington, J., Mannick, J.: Renal transplantation in two cases of amyloidosis.Lancet, 2, 513 (1971).
Dormann, S., Gamelli, R., Benzinger, J., Trainer, T. D., Foster, R. S.: Systemic amyloidosis involving two renal transplants.Hum. Pathol., 12, 735 (1981).
Frenzel, H., Schwartzkopff, B., Kuhn, H., Lösse, B., Thormann, J., Hart, W., Linke, R. P.: Cardiac amyloid deposits in endomyocardial biopsies.Am. J. Clin. Pathol., 85, 674 (1986).
Gerlag, P. G. G., Koene, R. A. P., Berden, J. H. M.: Renal transplantation in light chain nephropathy. Case report and review of the literature.Clin. Nephrol., 25, 101 (1986).
Gurland, H. J., Brunner, F., Chantler, C., Jacobs, C., Schärer, K., Seelwood, N. H., Spier, G., Wing, A. J.: Combined report on regular dialysis and transplantation in Europe.Proc. Eur. Dial. Transpl. Assoc., 13, 3 (1975).
Helin, H., Pasternak, A., Falck, H., Kuhlbäck, B.: Recurrence of renal amyloid and de novo membranous glomerulonephritis after transplantation.Transplantation, 32, 6 (1981).
Jacob, E. T., Siegel, B., Bar-Nathan, N., Gafni, J.: Improving outlook for renal transplantation in amyloid nephropathy.Transpl. Proc., 14, 41 (1982).
Jacob, E. T.: Renal transplant in the amyloidosis of familial Mediterranean fever.Arch. Int. Med., 139, 1135 (1977).
Jones, M., Adams, J., Passer, J. A.: Amyloidosis in a renal allograft in familial Mediterranean fever.Ann. Int. Med., 87, 579 (1977).
Jones, N. F.: Renal amyloidosis.Clin. Nephrol., 6, 459 (1975).
Kennedy, C. L., Castro, J. E.: Transplantation for renal amyloidosis.Transplantation, 24, 382 (1977).
Kuhlbäck, B., Falck, H., Törnroth, T., Wallenius, M., Lindström, B. L., Pasternack, A.: Renal transplantation in amyloidosis.Acta Med. Scand., 205, 169 (1979).
Kyle, R. A., Bayrd, E. D.: Amyloidosis: Review of 236 cases.Medicine, 54, 271 (1975).
Light, P. D., Hall-Craggs, M.: Amyloid deposition in a renal allograft in a case of renal amyloidosis due to rheumatoid arthritis.Am. J. Med., 66, 532 (1979).
Linke, R. P.: Monoclonal antibodies against amyloid fibril protein AA, Production, specificity and use for immunohistochemical localization and classification of AA-type amyloidosis.J. Histochem. Cytochem., 32, 322 (1984).
Linke, R. P., Nahrath, W. B. G.: Klassifizierung von Amyloidkrankheiten an der Biopsie. Anwendung der Immunperoxydasetechnik.MMW, 122, 1772 (1980).
Löffler, H. J., Brass, H., Thoenes, W., Linke, R. P.: Familiäres Mittelmeerfieber mit Amyloidose.Dtsch. Med. Wochenschr., 108, 210 (1983).
Martin, J. H., Brown, A., Daugherty, G. W.: Renal amyloidosis—biopsy study.Am. J. Med. Sci., 259, 129 (1966).
Metaxas, P.: Familial Mediterranean fever and amyloidosis.Kidney Int., 20, 676 (1981).
Pasternack, A., Ahonen, J., Kuhlbäck, B.: Renal transplantation on 45 patients with amyloidosis.Transplantation, 42, 598 (1986).
Ravid, M., Shapira, J., Lang, R., Kedar, J.: Prolonged dimethylsulfoxide treatment in 13 patients with systemic amyloidosis.J. Rheumat. Dis., 41, 587 (1982).
Rubinger, D., Friedländer, M. M., Popoutzer, M. M.: Amelioration of familial Mediterranean fever during hemodialysis.N. Engl. J. Med., 302, 142 (1979).
Siegal, B., Zemer, D., Pras, M.: Cyclosporine and familial Mediterranean fever amyloidosis.Transplantation, 41, 793 (1986).
Sohar, E., Gafni, J., Pras, M., Heller, H.: Familial Mediterranean fever: A survey of 470 cases and review of the literature.Am. J. Med., 43, 227 (1967).
Thoenes, W., Schneider, H. M.: Human glomerular amyloidosis with special regard to proteinuria and amyloidogenesis.Klin. Wochenschr., 58, 667 (1980).
Triger, D., Joekes, A.: Renal amyloidosis—a fourteen-year follow up.Q. J. Med., 42, 15 (1973).
van Rijswijk, M. H., van Leuwen, M. A., Donker, A. J. M., Mandema, E.: Treatment of systemic amyloidosis. In: G. Glenner et al. (eds): Amyloidosis. Plenum Press, New York 1986, pp. 571–582.
Zemer, D., Pras, M., Sohar, E.: Colchicine in the prevention and treatment of the amyloidosis of familial Mediterranean fever.N. Engl. J. Med., 314, 1001 (1986).
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Heering, P., Kutkuhn, B., Frenzel, H. et al. Renal transplantation in amyloid nephropathy. International Urology and Nephrology 21, 339–347 (1989). https://doi.org/10.1007/BF02559746
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02559746