Introduction: Kidney transplantation is an appropriate treatment option for renal AA amyloidosis. Occurrence of amyloidosis may be seen in the transplanted kidney as other glomerulonephritis. The aim of the study is to determine rate of amyloid recurrence and to evaluate patient graft and patient survival among patients who underwent kidney transplantation secondary to renal AA amyloidosis.

Method: This is a retrospective cohort study. The study included patients who underwent kidney transplantation secondary to end-stage kidney disease caused by AA amyloidosis between January 1995 and December 2021. Demographic and clinical findings were retrospectively obtained from hospital electronic patient management system. Patients underwent surveillance biopsy in the absence of graft dysfunction, hematuria, proteinuria. Allograft biopsies were classified as for-cause biopsy in the presence of graft dysfunction and proteinuria.

Results: 82 kidney transplants were included in the study. Age at the time of transplantation was 37.2 ± 12.2 years and 65.9% were male. Living donor transplantation was done in 63.4% of patients. The follow-up period was 9.5±6.2 years. The amyloid recurrence rate was 34.1% during the follow-up period and 28.5% of these were detected by surveillance biopsies. Overall graft survival and patient survival were similar between recurrent and non-recurrent group (respectively, p=0.84 and p=0.12). Based on the multiple regression analysis adjusted for age and gender, no significant relationship was detected between the presence of amyloid recurrence and mortality (p=0.19). 

Conclusion: Kidney transplantation is an optimal treatment option in patients with end-stage kidney disease secondary to AA amyloidosis. Amyloid recurrence may occur in the transplanted kidney. Performing a surveillancebiopsy may be helpful in early diagnosis of recurrence.