Author/Authors :
Yeo, Min-kyung Department of Pathology - Chungnam National University School of Medicine, Daejeon, Republic of Korea , Ham, Young Rok Department of Nephrology - Chungnam National University School of Medicine, Daejeon, Republic of Korea , Choi, Song-Yi Department of Pathology - Chungnam National University School of Medicine, Daejeon, Republic of Korea , Lee, Yong-Moon Department of Pathology - Chungnam National University School of Medicine, Daejeon, Republic of Korea , Park, Moon Hyang Department of Pathology - Konyang University Hospital, Daejeon, Republic of Korea , Suh, Kwang-Sun Department of Pathology - Chungnam National University School of Medicine, Daejeon, Republic of Korea
Abstract :
Kidney transplantation for amyloidosis remains a contentious issue.
Recurrence of amyloidosis is one of the risks of transplantation.
Chronic active antibody-mediated rejection is an important cause
of chronic allograft dysfunction. A 47-year-old woman underwent
kidney transplantation due to renal AA amyloidosis with unknown
etiology. Six years posttransplantation, a kidney biopsy showed
AA amyloidosis with chronic active antibody-mediated rejection.
Donor-specific antibody class II was positive. The patient underwent
intravenous plasmapheresis and treatment with rituximab and
colchicine. The relationship between recurrence of amyloidosis
and rejection was not obvious. Clinical characteristics of kidney
transplantation for AA amyloidosis were subjected to literature
review and 315 cases were identified. The incidence of amyloidosis
recurrence and acute and chronic rejection rates were 15%, 15%, and
8%, respectively. Five-year patient and graft survival rates were 77%
and 82%, respectively. Clinical courses of kidney transplantation
in AA amyloidosis were, thus, identified.
Keywords :
allograft rejection , recurrence , kidney transplantation , Amyloidosis
