Kidney Week

Abstract: SA-PO844

Postkidney Transplant Outcomes among Patients with Prior Diagnosis of Leukocyte Chemotactic Factor 2 (ALECT2)-Associated Amyloidosis: A Case Series

Session Information

• C3G, TMA, MGRS, Amyloidosis, and More
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Garcia, Pablo, The University of New Mexico, Albuquerque, New Mexico, United States

Pablo Garcia, MD, FASN

• Avila, Paul Brandon, Universidad de San Carlos de Guatemala Facultad de Ciencias Medicas, Guatemala, Guatemala, Guatemala

Paul Brandon Avila, MD

• Vasquez-Rios, George, Renal Medical Associates, Alburquerque, New Mexico, United States

George Vasquez-Rios, MD, MS

• Singh, Namita, The University of New Mexico, Albuquerque, New Mexico, United States

Namita Singh, MBBS, MD, FASN

• Shaffi, Saeed Kamran, The University of New Mexico, Albuquerque, New Mexico, United States

Saeed Kamran Shaffi, MD, MS

• Argyropoulos, Christos, The University of New Mexico, Albuquerque, New Mexico, United States

Christos Argyropoulos, MD, PhD

Introduction

ALECT2 amyloidosis, a prevalent form of amyloidosis in the Soutwestern US mainly New Mexico, predominantly affects Hispanic patients and often leads to kidney failure 35%. Notably, long-term outcomes in kidney transplant recipients with ALECT2-associated kidney failure remain understudied. This study fills this gap by analyzing long-term outcomes in this specific patient population.

Case Description

Three patients, aged 45 to 78 years, were diagnosed with ALECT2 based on kidney biopsy findings. All patients underwent kidney transplantation and received immunosuppressive therapy, which included various combinations of envarus, mycophenolate, tacrolimus, and/or prednisone. Details of each case are summarized in the accompanying table. During the follow-up period, ranging from 8 to 60 months, all patients remained stable with preserved estimated glomerular filtration rate (eGFR) and minimal or no urinary protein-to-creatinine ratio (UPCR).

Discussion

The most comprehensive cohorts in ALECT 2 with a follow-up of 30-50 months indicate a higher risk of rapid progression to ESKD in patients with biopsy-proven ALECT2. However, in this post-kidney transplant cohort with long-term follow-up – up to 60 months, there is no evidence of clinically significant renal ALECT2 recurrence. Further research is needed to determine the long-term kidney outcomes among post-transplant recipients with ALECT2.