Elsevier

Transplantation Proceedings

Volume 43, Issue 6, July–August 2011, Pages 2418-2420
Transplantation Proceedings

Case report
Kidney
A Case of Living-Donor Renal Transplantation for Chronic Renal Failure Caused by Secondary Amyloidosis

https://doi.org/10.1016/j.transproceed.2011.05.035Get rights and content

Abstract

In Japan, amyloidosis is a rare cause of renal failure and of renal transplantation. We treated a patient who underwent a renal transplantation because of chronic renal failure caused by secondary amyloidosis with a good result. The patient was a 50-year-old woman who was diagnosed with secondary amyloidosis and an amyloid kidney. She underwent living donor renal transplantation after about 7 years of hemodialysis. During the 3-year posttransplantation period, she maintained good allograft function with a serum creatinine level about 1.2 mg/dL. Because of amyloidosis is a systemic disease, amyloid kidney patients often experience fatal complications, so the indications for renal transplantation in amyloid patients are still controversial. But if the patient's general condition is good, renal transplantation can be an effective therapy for patients with kidney failure caused by amyloidosis.

Section snippets

Case Report

The patient was a 50-year-old woman who at age 38 years was diagnosed with acute renal failure. Renal biopsy revealed deposition of AA amyloid and the cause of renal failure was secondary amyloidosis. Consistent with secondary amyloidosis, we suspected aortitis syndrome from imaging findings, eg, stenosis of the subclavian artery, but could not confirm the diagnosis.

Although she began steroid therapy, the renal function worsened progressively, and she started hemodialysis at the age of 40

Discussion

AA-type amyloidosis mostly develops due to a chronic inflammatory disease, for example, tuberculosis, rheumatoid arthritis, or an autoimmune disease. Patients with AA-type amyloidosis show amyloid protein deposits in glomeruli, vessels, renal tubules, and interstitial tissues. In many cases, the amyloid deposition decreases renal function, resulting in renal failure. Amyloid protein can also deposit in other vital organs (eg, heart and liver), leading to cardiac or liver dysfunction. The

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