Solid Organ Transplantation in AL Amyloidosis

被引：92

作者：

Sattianayagam, P. T. ^{[1
]}

Gibbs, S. D. J. ^{[1
]}

Pinney, J. H. ^{[1
]}

Wechalekar, A. D. ^{[1
]}

Lachmann, H. J. ^{[1
]}

Whelan, C. J. ^{[1
]}

Gilbertson, J. A. ^{[1
]}

Hawkins, P. N. ^{[1
]}

Gillmore, J. D. ^{[1
]}

机构：

[1] UCL, Sch Med, Natl Amyloidosis Ctr, Dept Med,Ctr Amyloidosis & Acute Phase Prot, London W1N 8AA, England

来源：

AMERICAN JOURNAL OF TRANSPLANTATION | 2010年 / 10卷 / 09期

基金：

英国医学研究理事会;

关键词：

AL amyloidosis; amyloid; amyloidosis; heart transplantation; kidney transplantation; liver transplantation; PRIMARY SYSTEMIC AMYLOIDOSIS; STEM-CELL TRANSPLANTATION; LIGHT-CHAIN AMYLOIDOSIS; LONG-TERM SURVIVAL; KIDNEY-TRANSPLANTATION; LIVER-TRANSPLANTATION; HEART-TRANSPLANTATION; CARDIAC AMYLOIDOSIS; CLINICAL-FEATURES; NATURAL-HISTORY;

D O I：

10.1111/j.1600-6143.2010.03227.x

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Vital organ failure remains common in AL amyloidosis. Solid organ transplantation is contentious because of the multisystem nature of this disease and risk of recurrence in the graft. We report outcome among all AL patients evaluated at the UK National Amyloidosis Centre who received solid organ transplants between 1984 and 2009. Renal, cardiac and liver transplants were performed in 22, 14 and 9 patients respectively, representing < 2% of all AL patients assessed during the period. One and 5-year patient survival was 95% and 67% among kidney recipients, 86% and 45% among heart recipients and 33% and 22% among liver recipients. No renal graft failed due to recurrent amyloid during median (range) follow up of 4.8 (0.2-13.3) years. Median patient survival was 9.7 years among 8/14 cardiac transplant recipients who underwent subsequent stem cell transplantation (SCT) and 3.4 years in six patients who did not undergo SCT (p = 0.01). Amyloid was widespread in all liver transplant recipients. Solid organ transplantation has rarely been performed in AL amyloidosis, but these findings demonstrate feasibility and support a role in selected patients.

引用

页码：2124 / 2131

页数：8

共 29 条

[1] High-dose intravenous melphalan with autologous stem cell transplantation in AL amyloidosis-associated end-stage renal disease [J].