Donor-derived ALECT2 Amyloidosis in a Transplant Allograft: A Rare Scenario

Leukocyte chemotactic factor 2 amyloidosis is a recently recognized entity that often affects the kidneys. Little information is available regarding kidney transplant outcomes in patients with LECT2 amyloidosis or who received kidney allografts containing LECT2 amyloid. We present the clinical cours...

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Main Authors: Kanupriya Agrawal, Mahendra Meena, Arjun Agarwal, Rakesh Gupta, Dhananjai Agarwal
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:Indian Journal of Transplantation
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Online Access:https://journals.lww.com/10.4103/ijot.ijot_95_24
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author Kanupriya Agrawal
Mahendra Meena
Arjun Agarwal
Rakesh Gupta
Dhananjai Agarwal
author_facet Kanupriya Agrawal
Mahendra Meena
Arjun Agarwal
Rakesh Gupta
Dhananjai Agarwal
author_sort Kanupriya Agrawal
collection DOAJ
description Leukocyte chemotactic factor 2 amyloidosis is a recently recognized entity that often affects the kidneys. Little information is available regarding kidney transplant outcomes in patients with LECT2 amyloidosis or who received kidney allografts containing LECT2 amyloid. We present the clinical course and outcome of a patient who received a kidney with donor-derived LECT2 amyloidosis. The patient was a 30-year-old male who received live-related renal allograft from a 57-year-old female. Allograft biopsy was done on day 7 posttransplant due to slow graft function with creatinine = 1.9 mg/dl. Biopsy was consistent with the findings of thrombotic microangiopathy (TMA) with donor-derived interstitial amyloid deposition staining positive for ALECT2. TMA was probably de novo due to dose-dependent tacrolimus toxicity. Tacrolimus level was around 14 ng/ml on 3 mg BD as given according to body weight 0.1 mg/kg. After reducing the dose, creatinine level reduced to 1.1 mg/dl. The donor was thoroughly evaluated for cause and any systemic manifestation of amyloidosis; she also did not develop any systemic manifestations yet. After 1-year regular follow-up, the recipient is maintaining well with creatinine around 1 mg/dl. The indolent posttransplantation course suggests that donated kidneys with ALECT2 amyloidosis may be suitable for transplantation, but the deposits persist for many years.
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spelling doaj-art-fcc531f45cda43ab8c4ac0a4c37c86b12025-07-04T07:39:49ZengWolters Kluwer Medknow PublicationsIndian Journal of Transplantation2212-00172212-00252025-04-0119223423610.4103/ijot.ijot_95_24Donor-derived ALECT2 Amyloidosis in a Transplant Allograft: A Rare ScenarioKanupriya AgrawalMahendra MeenaArjun AgarwalRakesh GuptaDhananjai AgarwalLeukocyte chemotactic factor 2 amyloidosis is a recently recognized entity that often affects the kidneys. Little information is available regarding kidney transplant outcomes in patients with LECT2 amyloidosis or who received kidney allografts containing LECT2 amyloid. We present the clinical course and outcome of a patient who received a kidney with donor-derived LECT2 amyloidosis. The patient was a 30-year-old male who received live-related renal allograft from a 57-year-old female. Allograft biopsy was done on day 7 posttransplant due to slow graft function with creatinine = 1.9 mg/dl. Biopsy was consistent with the findings of thrombotic microangiopathy (TMA) with donor-derived interstitial amyloid deposition staining positive for ALECT2. TMA was probably de novo due to dose-dependent tacrolimus toxicity. Tacrolimus level was around 14 ng/ml on 3 mg BD as given according to body weight 0.1 mg/kg. After reducing the dose, creatinine level reduced to 1.1 mg/dl. The donor was thoroughly evaluated for cause and any systemic manifestation of amyloidosis; she also did not develop any systemic manifestations yet. After 1-year regular follow-up, the recipient is maintaining well with creatinine around 1 mg/dl. The indolent posttransplantation course suggests that donated kidneys with ALECT2 amyloidosis may be suitable for transplantation, but the deposits persist for many years.https://journals.lww.com/10.4103/ijot.ijot_95_24alect2 amyloidde novo donor amyloidosisdonor amyloidosis
spellingShingle Kanupriya Agrawal
Mahendra Meena
Arjun Agarwal
Rakesh Gupta
Dhananjai Agarwal
Donor-derived ALECT2 Amyloidosis in a Transplant Allograft: A Rare Scenario
Indian Journal of Transplantation
alect2 amyloid
de novo donor amyloidosis
donor amyloidosis
title Donor-derived ALECT2 Amyloidosis in a Transplant Allograft: A Rare Scenario
title_full Donor-derived ALECT2 Amyloidosis in a Transplant Allograft: A Rare Scenario
title_fullStr Donor-derived ALECT2 Amyloidosis in a Transplant Allograft: A Rare Scenario
title_full_unstemmed Donor-derived ALECT2 Amyloidosis in a Transplant Allograft: A Rare Scenario
title_short Donor-derived ALECT2 Amyloidosis in a Transplant Allograft: A Rare Scenario
title_sort donor derived alect2 amyloidosis in a transplant allograft a rare scenario
topic alect2 amyloid
de novo donor amyloidosis
donor amyloidosis
url https://journals.lww.com/10.4103/ijot.ijot_95_24
work_keys_str_mv AT kanupriyaagrawal donorderivedalect2amyloidosisinatransplantallograftararescenario
AT mahendrameena donorderivedalect2amyloidosisinatransplantallograftararescenario
AT arjunagarwal donorderivedalect2amyloidosisinatransplantallograftararescenario
AT rakeshgupta donorderivedalect2amyloidosisinatransplantallograftararescenario
AT dhananjaiagarwal donorderivedalect2amyloidosisinatransplantallograftararescenario