Supportive therapy in systemic amyloidosis. Supportive treatment is a fundamental part of the management of patients with systemic AL amyloidosis and is aimed at sustaining organ function while specific therapy is delivered, as well as at improving quality of life. Transplantation of the organs involved by amyloidosis may render patients with advanced disease eligible for aggressive specific treatment. The main concerns with organ transplantation are recurrence of amyloidosis in the graft and progression in other organs. However, the availability of effective anticlone treatments and the ever-improving long-term survival of patients with AL amyloidosis allow considering organ transplant in an increasing proportion of patients. Heart transplant followed by ASCT or other effective chemotherapy can be the only effective option for young patients with isolated, severe cardiac involvement. Moreover, organ transplant can be considered in patients who attain complete response, but have irreversible end-stage organ damage. ACE, angiotensin-converting enzyme; ICD, implantable cardioverter defibrillator.