Patient and Kidney Allograft Survival in Recipients with End-Stage Renal Disease from Amyloidosis

Academic Article

Abstract

  • © 2018 Wolters Kluwer Health, Inc. All rights reserved. Background Outcomes after kidney transplantation for patients with amyloidosis-Associated end-stage renal disease (ESRD) have not been well characterized. Methods We performed a retrospective propensity score matched cohort study with Cox proportional hazards modeling using data from the United Network of Organ Sharing including patients transplanted from 1987 to 2015 (N = 310 629). Results Amyloidosis patients (N = 576) had higher rates of death (hazard ratio [HR], 1.58; 95% confidence interval [CI], 1.28-1.95) and graft loss (HR, 1.49; 95% CI, 1.19-1.87) compared with nonamyloidosis patients. The results were similar when the cohort was restricted to patients transplanted on or after 2001 (HR, 1.72; 95% CI, 1.31-2.26 for death; HR, 1.77; 95% CI, 1.35-2.33 for graft loss). However, there was no significant difference in risk of death or graft loss when amyloidosis patients were compared with those with diabetes-Associated ESRD (mortality: HR, 0.99; 95% CI, 0.84-1.17; allograft loss: HR, 1.00; 95% CI, 0.84-1.20), or when compared with elderly patients (age, >65 years at the time of transplant) (mortality: HR, 0.99; 95% CI, 0.81-1.21; graft loss: HR, 1.02; 95% CI, 0.82-1.26). Conclusions For patients with amyloidosis-Associated ESRD deemed suitable for transplantation, patient and graft survivals are diminished compared to kidney transplant recipients overall, but are comparable to other high-risk subgroups.
  • Authors

    Digital Object Identifier (doi)

    Author List

  • Sawinski D; Lim MA; Cohen JB; Locke JE; Weiss B; Hogan JJ; Dember LM
  • Start Page

  • 300
  • End Page

  • 309
  • Volume

  • 102
  • Issue

  • 2