Patient characteristics at presentation and during heart transplantation
. | Age at diagnosis of amyloid, y . | Time from amyloid diagnosis to heart transplantation, mo . | ECHO IVS LVPW thickness, mm . | Extracardiac amyloid by SAP scan, total load/organs . | Serum creatinine, μmol/L (proteinuria, d) . | Plasma cell dyscrasia . | . | . | . | . | No. rejection episodes (time after transplantation, wk) . | . | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Patient . | . | . | . | . | . | PCs, % . | FLC(κ),*mg/L . | FLC(λ),*mg/L . | κ/λ,*ratio . | LOS after transplantation, d . | . | ISHLT rejection grade . | |||
| 1 | 56 | 4 | 18/17 | Small/spleen, kidneys | 97/0.1 | 7 | 349 | 44.3 | 7.9 | 14 | 2 (8, 20) | 2, 3A | |||
| 2† | 59 | 9 | 19/17 | Small/spleen, kidneys | 89/0.17 | 7 | 5.1 | 129 | 0.04 | 22 | 1 (25) | 3A | |||
| 3 | 44 | 2 | 17/18 | Small/none | 108/0.6 | 7 | 4.0 | 342 | 0.01 | 24 | 1 (5) | 3A | |||
| 4 | 38 | 4 | 15/15 | Small/spleen | 113/0.3 | 15 | 1.4 | 479 | 0.00 | 28 | 0 | – | |||
| 5 | 53 | 8 | 17/16 | Small/spleen, kidneys | 119/0.6 | <5 | 1040 | 23.8 | 43.7 | 30 | 0 | – | |||
. | Age at diagnosis of amyloid, y . | Time from amyloid diagnosis to heart transplantation, mo . | ECHO IVS LVPW thickness, mm . | Extracardiac amyloid by SAP scan, total load/organs . | Serum creatinine, μmol/L (proteinuria, d) . | Plasma cell dyscrasia . | . | . | . | . | No. rejection episodes (time after transplantation, wk) . | . | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Patient . | . | . | . | . | . | PCs, % . | FLC(κ),*mg/L . | FLC(λ),*mg/L . | κ/λ,*ratio . | LOS after transplantation, d . | . | ISHLT rejection grade . | |||
| 1 | 56 | 4 | 18/17 | Small/spleen, kidneys | 97/0.1 | 7 | 349 | 44.3 | 7.9 | 14 | 2 (8, 20) | 2, 3A | |||
| 2† | 59 | 9 | 19/17 | Small/spleen, kidneys | 89/0.17 | 7 | 5.1 | 129 | 0.04 | 22 | 1 (25) | 3A | |||
| 3 | 44 | 2 | 17/18 | Small/none | 108/0.6 | 7 | 4.0 | 342 | 0.01 | 24 | 1 (5) | 3A | |||
| 4 | 38 | 4 | 15/15 | Small/spleen | 113/0.3 | 15 | 1.4 | 479 | 0.00 | 28 | 0 | – | |||
| 5 | 53 | 8 | 17/16 | Small/spleen, kidneys | 119/0.6 | <5 | 1040 | 23.8 | 43.7 | 30 | 0 | – | |||
All patients were male and had NYHA (New York Heart Association) class IV heart failure. ECHO indicates echocardiography; IVS, intraventricular septum; LVPW, left ventricular posterior wall; PCs, plasma cells in bone marrow; LOS, length of stay in the hospital; ISHLT, International Society of Heart and Lung Transplantation; and –, not applicable.
Normal ranges are as follows: FLC(K), 3.3-19.4 mg/L; FLC(λ), 5.7-26.3 mg/L; and k/λ ratio, 0.26-1.65
Patient 2 received cyclical intravenous melphalan and oral dexamethasone before heart transplantation (see “Patients”)