Outcomes in renal transplant recipients with lupus nephritis: experience at a single center

Ren Fail. 2014 Jul;36(6):912-5. doi: 10.3109/0886022X.2014.915196. Epub 2014 May 6.

Abstract

Background: The long-term prognosis of renal transplant recipients with systemic lupus erythematosus is still controversial. The outcome of these patients depends on the population studied, race/ethnicity, socioeconomic conditions, donor-related factors and recurrent lupus nephritis (LN), among other factors.

Objective: This study was conducted to evaluate kidney transplantation outcomes for adult Brazilian patients with LN at a single center.

Subjects and method: The archival records of all patients with LN who had received a kidney transplant at Santa Casa of Sao Paulo Hospítal were reviewed. Kaplan-Meier method was used to determine the survival rate.

Results: We identified 18 patients with LN subjected to 22 kidney transplants during the 20-year interval. Two patients received three renal grafts. The majority of the patients were female, with 33.7 ± 10 years at the time of the transplantation, and half of them were African descendants or mixed. Sixteen transplants were performed from deceased donors and six from living-related donors. The patient survival rate was 90%, and graft survival was 68% at 10 years. Chronic allograft nephropathy was the major cause of graft loss. Two patients developed extra-renal manifestations of lupus. There was no clinical or histological evidence of recurrent LN.

Conclusion: Renal transplantation is a method which can provide a long-term survival for patients with SLE and end-stage renal disease.

Keywords: Lupus nephritis; outcome; renal transplantation; survival; systemic lupus erythematosus.

MeSH terms

  • Female
  • Humans
  • Kidney Transplantation*
  • Lupus Nephritis / surgery*
  • Male
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult