Original investigationsTransplantationThe Long-Term Prognosis of Renal Transplantation in Patients With Lupus Nephritis
Section snippets
Patients
Adult (>18 years) patients with SLE who received a kidney transplant at Ospedale Maggiore, Milan, Italy, between June 1982, when the first renal transplantation in a patient with lupus nephritis was performed, and January 2004 were admitted to the study. The diagnosis of SLE had to match American College of Rheumatology criteria.16 The diagnosis of lupus nephritis was based on clinical and serological criteria,16 as well as renal biopsy, according to the World Health Organization classification.
Results
We performed the first renal transplantation in a patient with SLE in June 1982. Since then, of 1,302 renal transplantations performed up to January 2004, a total of 35 renal transplantations (2.8%) in 33 patients with a diagnosis of lupus nephritis were performed (2 patients received 2 renal transplants). Eleven of these transplantations were performed between 1982 and 1990, 21 were performed between 1991 and 2000, and 3 were performed after 2000. Twenty-six of these patients (79%) had
Discussion
There is general agreement that patient survival is similar in adult renal transplant recipients with or without SLE, although only a few studies reported results at 10 years.5, 7, 11, 12 Instead, controversy still exists about kidney allograft survival in patients with SLE. Only 7 studies compared graft outcomes of transplant recipients with SLE with those of well-matched controls. In 2 of these studies, renal graft survival was lower in patients with than without lupus.5, 6 In another 5
References (26)
- et al.
Antiphospholipid antibodies are associated with an increased risk for chronic renal insufficiency in patients with lupus nephritis
Am J Kidney Dis
(2004) Outcomes of renal transplantation among patients with end-stage renal disease caused by lupus nephritis
Kidney Int
(2000)- et al.
Risk factors for renal allograft loss in patients with systemic lupus erythematosus
Kidney Int
(1996) - et al.
The Banff 97 working classification of renal allograft pathology
Kidney Int
(1999) - et al.
Antiphospholipid antibody syndrome in renal transplantationOccurrence of clinical events in 96 consecutive patients with systemic lupus erythematosus
Am J Kidney Dis
(1999) - et al.
End stage renal disease and systemic lupus erythematosus
Am J Med
(1996) Lupus nephritis
J Am Soc Nephrol
(1999)- et al.
Renal flares are common in patients with severe proliferative lupus nephritis treated with pulse immunosuppressive therapy
Arthritis Rheum
(2002) Renal transplantation in congenital and metabolic diseasesA report from ASC/NIH renal transplant registry
JAMA
(1975)- et al.
Outcome of renal transplantation in ninety-seven cyclosporine era patients with systemic lupus erythematosus and matched controls
Arthritis Rheum
(1998)
Renal transplantation in patients with systemic lupus erythematosusIncreased risk of early graft loss
Scand J Urol Nephrol
Single-center 1-15 year results of renal transplantation in patients with systemic lupus erythematosus
Transplantation
Long-term outcome of kidney transplantation in patients with systemic lupus erythematosusA multicenter study
Transplantation
Cited by (103)
Recurrence of disease following organ transplantation in autoimmune liver disease and systemic lupus erythematosus
2020, Cellular ImmunologyCitation Excerpt :Low complement after transplantation is the most relevant factor for recurrence of lupus nephritis [132,133]. Anti-phospholipid antibody syndrome (APS) is often associated with SLE, and increases the risk of post-transplant thrombosis in the renal transplantation [134,129,135]. According to a surveillance-biopsy based study [122], the majority of the patients of biopsy-proven recurrent lupus nephritis had subclinical class I or II (17 of 22), while 3 of 22 had class III or IV.
Kidney transplantation in systemic lupus erythematosus: Outcomes and prognosis
2019, Medicina ClinicaLupus Nephritis and Kidney Transplantation: Where Are We Today?
2019, Advances in Chronic Kidney DiseaseLong-term outcomes in lupus patients receiving different renal replacement therapy
2019, Journal of Microbiology, Immunology and InfectionPost-transplant Lupus Nephritis Recurrence: A Case Report and Review of the Literature
2019, Transplantation ProceedingsCurrent insights about recurrence of glomerular diseases after renal transplantation
2018, Nephrologie et Therapeutique
Originally published online as doi:10.1053/j.ajkd.2005.01.038 on March 16, 2005.
Supported in part by the grant Project in Glomerulonephritis in memory of Pippo Neglia. C.P. is an external consultant of Novartis Italy.