{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T20:31:50Z","timestamp":1786480310588,"version":"build-2736575974"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"published-print":{"date-parts":[[2021,12]]},"abstract":"\n Key Points<\/jats:title>\n \n \n \n Patient survival was viewed by amyloidosis and transplant program respondents as the most important determinant of transplant suitability.<\/jats:p>\n <\/jats:list-item>\n \n Amyloidosis program respondents were less concerned than transplant program respondents about extrarenal involvement.<\/jats:p>\n <\/jats:list-item>\n \n Overall, there was a lack of consensus across specialties about criteria for kidney transplantation for patients with amyloid light chain amyloidosis.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n Historically, kidney transplantation has been considered inappropriate for most patients with AL amyloidosis\u2013associated kidney failure because of concerns about recurrent disease in the allograft and poor long-term survival. With improvements in rates and durability of hematologic responses and survival that have accompanied treatment advances, a greater proportion of patients with AL amyloidosis may be suitable for kidney transplantation. However, there are no widely accepted criteria for kidney transplant eligibility for this patient population.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We administered surveys electronically to transplant nephrologists and amyloidosis experts at a geographically diverse set of academic medical centers in the United States. Questions were designed to elucidate views about suitability and timing of kidney transplantation for patients with AL amyloidosis\u2013associated kidney failure.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The survey was completed by 20 (65%) of invited amyloidosis experts and 20 (29%) of invited transplant physicians. Respondents indicated that, for patients with AL amyloidosis, most transplant nephrologists have limited experience with both determining eligibility for and providing care after kidney transplantation. Most transplant nephrologists and amyloidosis experts viewed anticipated patient survival as the most important determinant of suitability for kidney transplantation. Compared with transplant program respondents, amyloidosis program respondents reported a higher degree of confidence in determining suitability for kidney transplantation, were comfortable proceeding with kidney transplantation earlier after patients attained a hematologic response, and were less concerned about extrarenal amyloid involvement as a barrier to kidney transplantation. In both groups, most respondents indicated that there is a lack of consensus between amyloidosis and kidney transplant physicians about criteria for determining suitability for kidney transplantation.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Views about criteria for kidney transplantation for patients with AL amyloidosis\u2013associated kidney failure differed between amyloidosis and transplant nephrology program respondents, with amyloidosis specialists generally favoring a less-restrictive approach to transplant eligibility. The findings suggest a need for consensus building across specialties.<\/jats:p>\n <\/jats:sec>","DOI":"10.34067\/kid.0004232021","type":"journal-article","created":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T17:20:32Z","timestamp":1634232032000},"page":"1987-1997","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Suitability for Kidney Transplantation in AL Amyloidosis: A Survey Study of Transplant and Amyloidosis Physicians"],"prefix":"10.34067","volume":"2","author":[{"given":"Robert","family":"Lam","sequence":"first","affiliation":[{"name":"Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6269-4971","authenticated-orcid":false,"given":"Mary Ann","family":"Lim","sequence":"additional","affiliation":[{"name":"Renal-Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9735-7473","authenticated-orcid":false,"given":"Laura M.","family":"Dember","sequence":"additional","affiliation":[{"name":"Renal-Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"},{"name":"Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"},{"name":"Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,12,30]]},"reference":[{"key":"B1-20250825","doi-asserted-by":"crossref","first-page":"3458","DOI":"10.1681\/ASN.2006050460","article-title":"Amyloidosis-associated kidney disease","volume":"17","author":"Dember","year":"2006","journal-title":"J Am Soc Nephrol"},{"key":"B2-20250825","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/1750-1172-7-54","article-title":"Al amyloidosis","volume":"7","author":"Desport","year":"2012","journal-title":"Orphanet J Rare Dis"},{"key":"B3-20250825","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1182\/bloodadvances.2018016402","article-title":"Epidemiology of AL amyloidosis: A real-world study using US claims data","volume":"2","author":"Quock","year":"2018","journal-title":"Blood 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