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Nephrol Dial Transplant (1994) 9: 704-708
© 1994 European Renal Association-European Dialysis and Transplant Association

research-article

Study of live donor kidney transplantation outcome in recipients with renal amyloidosis

M. Sobh, A. Refaie, F. Moustafa, A. Shokeir, N. Hassan, S. Sally and M. Ghoneim

Urology and Nephrology Center, University of Mansoura Mansoura, Egypt

Correspondence and offprint requests to: Correspondence and offprint requests to: Dr Mohammed Sobh, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt

We studied the results of renal transplanta tion in 16 patients with renal amyloidosis and in 46 controls with primary glomerulonephritis. Amyloidosis was primary in five and secondary to familial Mediterranean fever (FMF) in 11. All patients received live related donor kidneys and the majority had onehaplotype HLA match. One- and 5-year graft and patient survival rates were comparable in both groups. Moreover, the frequency of acute rejection episodes and the mean serum creatinine values were not signi ficantly different between members of the two groups. Significant gastrointestinal symptoms in the form of nausea, vomiting, abdominal pains, and diarrhoea occurred in seven of the patients with amyloidosis (43.7%) and in only one of the controls (2%) (P=0.001). All seven recipients with amyloidosis who developed the gastrointestinal manifestations were receiving cyclosporin and six had FMF. Maintenance colchicine treatment prevented recurrence of FMF symptoms. In one patient discontinuation of colchicine was followed by recurrence of FMF symptoms. Recurrence of renal amyloidosis was not observed in five patients subjected to Trucut graft biopsies 1, 2, 3, 18 and 72 months post-transplantation.

It is concluded that live-related donor kidney transplantation is a safe procedure in patients with amyloidosis and follows a course similar to glomerulo nephritis patients.

Keywords: kidney transplantation; amyloidosis; famil ial Mediterranean fever


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