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.
BATUHAN BULAN, ISTANBUL UNIVERSITY-CERRAHPASA, CERRAHPASA MEDICAL FACULTY, INTERNAL MEDICINE DEPT., ISTANBUL, TURKEY

Main Body of the Abstract
Background: AL amyloidosis is caused by deposition of misfolded immunuglobulin light chains. There can be a rapid progression to ESKD. In this case report, we described a 63-year-old woman with de novo AL amyloidosis in renal allograft occurring after 4 years following kidney transplantation.
Case: A 63-year-old woman with a history of hypothyroidism, diabetes mellitus and nephrolithiasis underwent living donor kidney transplantation from her sister for ESKD in 2015. She presented with proteinuria in 2019. Laboratory investigations revealed creatinine 2.53 mg/dl, albumin 2.85 g/dl and urinary protein 8.8 g/day.  Renal allograft biopsy disclosed AL amyloidosis. IgG/lambda monoclonal protein was found. Serum free lambda light chain was 256 mg/l with a kappa/lambda ratio of 0.21. The bone marrow biopsy showed 10% lambda restricted plasma cells. The patient had stage IV (revised Mayo 2012) disease with heart, kidney and autonomic nervous system involvement. The native kidney tissue disclosed no evidence of amyloidosis. CyBorD was started and maintenance immunosuppression was continued. After 6 cycles, VGPR with organ response was achieved and maintained for 14 months. The patient died of COVID-19 pneumonia in 2021.
Summary and Conclusion: Recurrence of AL amyloidosis in a renal allograft after transplantation is not an uncommon scenario but de novo AL amyloidosis in kidney graft is extremely rare. The few cases reported and the patient described here are summarized in the table. AL amyloidosis should be included in the differential diagnosis of new onset albuminuria in a patient with kidney transplantation. Concomitant immunosuppressive therapy challenges treatment of these patients.

**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.**
BATUHAN BULAN, ISTANBUL UNIVERSITY-CERRAHPASA, CERRAHPASA MEDICAL FACULTY, INTERNAL MEDICINE DEPT., ISTANBUL, TURKEY

**Main Body of the Abstract**
**Background:** AL amyloidosis is caused by deposition of misfolded immunuglobulin light chains. There can be a rapid progression to ESKD. In this case report, we described a 63-year-old woman with de novo AL amyloidosis in renal allograft occurring after 4 years following kidney transplantation.
**Case:** A 63-year-old woman with a history of hypothyroidism, diabetes mellitus and nephrolithiasis underwent living donor kidney transplantation from her sister for ESKD in 2015. She presented with proteinuria in 2019. Laboratory investigations revealed creatinine 2.53 mg/dl, albumin 2.85 g/dl and urinary protein 8.8 g/day.  Renal allograft biopsy disclosed AL amyloidosis. IgG/lambda monoclonal protein was found. Serum free lambda light chain was 256 mg/l with a kappa/lambda ratio of 0.21. The bone marrow biopsy showed 10% lambda restricted plasma cells. The patient had stage IV (revised Mayo 2012) disease with heart, kidney and autonomic nervous system involvement. The native kidney tissue disclosed no evidence of amyloidosis. CyBorD was started and maintenance immunosuppression was continued. After 6 cycles, VGPR with organ response was achieved and maintained for 14 months. The patient died of COVID-19 pneumonia in 2021.
**Summary and Conclusion:** Recurrence of AL amyloidosis in a renal allograft after transplantation is not an uncommon scenario but de novo AL amyloidosis in kidney graft is extremely rare. The few cases reported and the patient described here are summarized in the table. AL amyloidosis should be included in the differential diagnosis of new onset albuminuria in a patient with kidney transplantation. Concomitant immunosuppressive therapy challenges treatment of these patients.

De Novo AL Amyloidosis In Renal Allograft-Case Report And Literature Review PA83 (#503)

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.