**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Ilias KOUNIS
Affiliations
1) AP-HP Hôpital Paul-Brousse, Centre Hépato-Biliaire, 94800, Villejuif, France
2) Inserm, Université Paris-Saclay, UMR-S 1193, 94800, Villejuif, France
3) Université Paris-Saclay, Inserm, Physiopathogénèse et traitement des maladies du Foie, 94805, Villejuif
4) France FHU Hepatinov, 94800, Villejuif, France

**Main Body of the Abstract**
Background and aims: Domino liver transplantation (DLT) is a crucial strategy in alleviating the organ shortage, yet the potential risk of transmitting the original disease presents a challenge in effectively informing recipients. 
Methods: This is a retrospective monocentric study, including adult patients who received dgrafts of donors with hereditary amyloid neuropathy between 1997 and 2022. The research employs Cox models to identify predictive factors for the development of neuropathy symptoms and for survival in these patients.
Results: A total of 183 patients underwent DLT, with a median follow-up of 12.4 [3.8, 20.1] years. Among them, 90 (49.2%) experienced neuropathy symptoms during a follow-up period of 11.4 [6.3, 17.8] years. Sensory loss and neuropathic pain were the prevalent symptoms, reported by 4 (2.4%) patients at 5 years post-LT, reaching 20 (14.5%) and 21 (21.2%) at 10 years. The survival rates were 84.9% at 5 years and 68.1% at 10 years. Death was attributed in 25 (20.3%)to cancer recurrence post-transplantation to amyloidosis in 5 (4.1%) cases. 125 (68.3%) donors carryed the Val MET 30 mutation.  The use of steroids (HR=1.53, p=0.05; HR=1.66, p=0.05) was a predicitve factor of post LT amyloisis symptoms. Cholangiocarcinoma as an indication for LT (HR=1.476, p=0.045) and the use of Tafamidis (HR=2.59, p=0.001) were identified as independent factors contributing to poor survival after LT in the multivariate analysis.
Conclusion: DLT demonstrated an equivalent survival rate compared to non-Domino liver transplantation, with survival primarily associated with the initial disease but half of the patients developed symptoms of amyloid neuropathy.



**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Ilias KOUNIS
## Affiliations
1) AP-HP Hôpital Paul-Brousse, Centre Hépato-Biliaire, 94800, Villejuif, France
2) Inserm, Université Paris-Saclay, UMR-S 1193, 94800, Villejuif, France
3) Université Paris-Saclay, Inserm, Physiopathogénèse et traitement des maladies du Foie, 94805, Villejuif
4) France FHU Hepatinov, 94800, Villejuif, France

**Main Body of the Abstract**
**Background and aims:** Domino liver transplantation (DLT) is a crucial strategy in alleviating the organ shortage, yet the potential risk of transmitting the original disease presents a challenge in effectively informing recipients. 
**Methods:** This is** **a retrospective monocentric study, including adult patients who received dgrafts of donors with hereditary amyloid neuropathy between 1997 and 2022. The research employs Cox models to identify predictive factors for the development of neuropathy symptoms and for survival in these patients.
**Results:** A total of 183 patients underwent DLT, with a median follow-up of 12.4 [3.8, 20.1] years. Among them, 90 (49.2%) experienced neuropathy symptoms during a follow-up period of 11.4 [6.3, 17.8] years. Sensory loss and neuropathic pain were the prevalent symptoms, reported by 4 (2.4%) patients at 5 years post-LT, reaching 20 (14.5%) and 21 (21.2%) at 10 years. The survival rates were 84.9% at 5 years and 68.1% at 10 years. Death was attributed in 25 (20.3%)to cancer recurrence post-transplantation to amyloidosis in 5 (4.1%) cases. 125 (68.3%) donors carryed the Val MET 30 mutation.  The use of steroids (HR=1.53, p=0.05; HR=1.66, p=0.05) was a predicitve factor of post LT amyloisis symptoms. Cholangiocarcinoma as an indication for LT (HR=1.476, p=0.045) and the use of Tafamidis (HR=2.59, p=0.001) were identified as independent factors contributing to poor survival after LT in the multivariate analysis.
**Conclusion:** DLT demonstrated an equivalent survival rate compared to non-Domino liver transplantation, with survival primarily associated with the initial disease but half of the patients developed symptoms of amyloid neuropathy.



RALTAN Study: Risk Assessment for acquired transthyretin Amyloid Neuropathyin Domino Liver Transplantation recipients PC28 (#144)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.