Titre :

Kidney Transplantation in Patients With AA Amyloidosis: Outcomes in a French Multicenter Cohort

Auteur(s) :

Schwarz, C. [Auteur]
Georgin-Lavialle, S. [Auteur]
Lombardi, Y. [Auteur]
Marion, O. [Auteur]
Jambon, F. [Auteur]
Legendre, C. [Auteur]
Marx, D. [Auteur]
Levi, C. [Auteur]
Toure, F. [Auteur]
Le Quintrec, M. [Auteur]
Bobot, M. [Auteur]
Matignon, M. [Auteur]
Dujardin, A. [Auteur]
Maanaoui, Mehdi [Auteur]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Cuozzo, S. [Auteur]
Jalal-Eddine, A. [Auteur]
Louis, K. [Auteur]
Mohamadou, I. [Auteur]
Brazier, F. [Auteur]
De Nattes, T. [Auteur]
Geneste, C. [Auteur]
Thervet, E. [Auteur]
Ducloux, D. [Auteur]
Mayet, V. [Auteur]
Kormann, R. [Auteur]
Lanot, A. [Auteur]
Duveau, A. [Auteur]
Zaidan, M. [Auteur]
Mesnard, L. [Auteur]
Ouali, N. [Auteur]
Rondeau, E. [Auteur]
Petit-Hoang, C. [Auteur]
Audard, V. [Auteur]
Deshayes, A. [Auteur]
Moktefi, A. [Auteur]
Rabant, M. [Auteur]
Buob, D. [Auteur]
François, H. [Auteur]
Luque, Y. [Auteur]

Titre de la revue :

American Journal of Kidney Diseases

Nom court de la revue :

Am J Kidney Dis

Numéro :

83

Pagination :

329-339

Éditeur :

Elsevier

Date de publication :

2023-09-21

ISSN :

1523-6838

Mot(s)-clé(s) en anglais :

AA amyloidosis
kidney transplantation
survival
Familial Mediterranean Fever (FMF)
biotherapies
anti-IL-1

Discipline(s) HAL :

Sciences du Vivant [q-bio]/Médecine humaine et pathologie

Résumé en anglais : [en]

ationale & Objective Outcomes of kidney transplantation for patients with renal AA amyloidosis are uncertain, with reports of poor survival and high rates of disease recurrence. However, data are inconclusive and mostly ...
Lire la suite >ationale & Objective Outcomes of kidney transplantation for patients with renal AA amyloidosis are uncertain, with reports of poor survival and high rates of disease recurrence. However, data are inconclusive and mostly based on studies from the early 2000s and earlier. Study Design Retrospective multicenter cohort study. Setting & Participants We searched the French national transplant database to identify all patients with renal AA amyloidosis who underwent kidney transplantation between 2008 and 2018. Exposures Age, cause of amyloidosis, use of biotherapies, CRP levels. Outcomes Outcomes were all-cause mortality and allograft loss. We also reported amyloidosis allograft recurrence, occurrence of acute rejection episodes, as well as infectious, cardiovascular, and neoplastic disease events. Analytical Approach The Kaplan-Meier estimator for mortality and the cumulative incidence function method for allograft loss. Factors associated with patient and allograft survival were investigated using a Cox proportional hazards model and a cause-specific hazards model, respectively. Results Eighty-six patients who received kidney transplants for AA amyloidosis at 26 French centers were included. The median age was 49.4 years (interquartile range 39.7-61.1). The main cause of amyloidosis was Familial Mediterranean Fever (37 cases, 43%). Sixteen (18.6%) patients received a biotherapy after transplantation. Patient survival was 94.0% (95% confidence interval 89.1-99.2) at 1 year and 85.5% (77.8-94.0) at 5 years post-transplantation. The cumulative incidence of allograft loss was 10.5% (4.0-17.0) at 1 year, and 13.0% (5.8-20.1) at 5 years post-transplantation. Histologically proven AA amyloidosis recurrence occurred in 5 transplants (5.8%). 55.8% of cases developed an infection requiring hospitalization and 27.9% acute allograft rejection. Multivariable analysis showed that CRP concentration at the time of transplantation was associated with patient survival (HR 1.01, 95% CI 1.00-1.02, p=0.01) and with allograft survival (HR 1.68, 95% CI 1.10-2.57, p 0.02). Limitations The study lacked a control group and the effect of biotherapies on transplantation outcomes could not be explored. Conclusions This relatively contemporary cohort of patients who received a kidney transplant for AA amyloidosis experienced favorable rates of survival and lower recurrence rates than previously reported. These data support the practice of treating these patients with kidney transplantation for end-stage kidney disease.Lire moins >

Langue :

Anglais

Comité de lecture :

Oui

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Autres travaux scientifiques

Date de dépôt :

2024-01-19T22:13:36Z
2024-04-26T09:36:35Z