Patient and Kidney Allograft Survival in Recipients with End Stage Renal Disease from Amyloidosis.
1Renal, Electrolyte and Hypertension Division, Hospital of the University of Pennsylvania, Philadelphia, PA
2Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
3Penn Amyloidosis Program, Division of Hematology-Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
4Division of Hematology/Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA
Meeting: 2017 American Transplant Congress
Abstract number: 346
Keywords: Kidney transplantation, Malignancy, Mortality, Outcome
Session Information
Date: Monday, May 1, 2017
Session Name: Concurrent Session: Kidney Clinical Complications 2
Session Time: 4:30pm-6:00pm
Presentation Time: 4:42pm-4:54pm
Location: E354b
Background: Data on patient and graft outcomes of kidney transplant recipients with end stage renal disease (ESRD) from systemic amyloidosis is scarce. Methods: We performed a retrospective cohort study using data from the United Network of Organ Sharing in patients transplanted from 1987 to 2015. We used multivariable Cox regression with and without propensity score matching to assess patient and graft outcomes of 576 patients with ESRD due to amyloidosis compared to 310,053 non-amyloidosis patients. Because diabetes and age were identified as significant effect modifiers, we also performed sensitivity analyses comparing patient and graft survival of amyloid patients to only those with ESRD listed as due to diabetes (DN), and to the elderly (age > 65 years at the time of transplant). Results: Amyloidosis patients were older (median age 57 vs. 50 yrs; p<0.001), more often Caucasian (81% vs 56%, p<0.001) and less likely to have received a deceased donor transplant (52% vs. 64%, p<0.001). In multivariable Cox regression they had higher rates of death (HR 1.85, 95%CI 1.60-2.13) and all cause graft loss (HR 1.62, 95% CI 1.38-1.89). In a 1:1 propensity score matched Cox analysis, amyloid patients had elevated rates of death (HR 1.37, 95% CI: 1.08-1.74) and graft loss (HR 1.66, 95% CI 1.30-2.12) compared to the non-amyloid patients, but had a similar risk of death (HR 0.83, 95% CI 0.65-1.06) and graft failure (HR 0.96, 95% CI 0.72-1.27) when compared to DN or elderly recipients (death, HR 0.83, 95% CI 0.57-1.20 and graft loss HR 0.85, 95% CI 0.56-1.28, respectively). Conclusion: Patient and graft survival are worse for patients with amyloidosis-associated ESRD than for those with other causes of ESRD, but are comparable to the elderly and to patients with ESRD from diabetic nephropathy.
CITATION INFORMATION: Lim M, Sawinski D, Cohen J, Weiss B, Hogan J, Dember L. Patient and Kidney Allograft Survival in Recipients with End Stage Renal Disease from Amyloidosis. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Lim M, Sawinski D, Cohen J, Weiss B, Hogan J, Dember L. Patient and Kidney Allograft Survival in Recipients with End Stage Renal Disease from Amyloidosis. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/patient-and-kidney-allograft-survival-in-recipients-with-end-stage-renal-disease-from-amyloidosis/. Accessed October 19, 2019.« Back to 2017 American Transplant Congress