Results and prognosis of kidney transplantation in lupus nephritis: Experience of an Argentine center.

Publisher: SAGE Publications Country of Publication: England NLM ID: 9204265 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1477-0962 (Electronic) Linking ISSN: 09612033 NLM ISO Abbreviation: Lupus Subsets: MEDLINE

Publication: London : SAGE Publications
Original Publication: Houndmills, Basingstoke, Hampshire, UK : Scientific & Medical Division, Macmillan Press Ltd., c1991-

Kidney Transplantation* ; Lupus Nephritis*/surgery ; Lupus Nephritis*/mortality ; Lupus Nephritis*/complications ; Graft Survival* ; Kidney Failure, Chronic*/surgery ; Kidney Failure, Chronic*/mortality; Humans ; Retrospective Studies ; Female ; Adult ; Male ; Argentina/epidemiology ; Middle Aged ; Prognosis ; Young Adult ; Graft Rejection ; Treatment Outcome

Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Introduction: Although RT has improved the survival of the population with ESRD due to all causes, renal outcomes in SLE are controversial. The objective of this study is to describe the characteristics and evolution of the patients and the kidney transplant in LN, and compare it with patients transplanted for other causes.
Materials and Methods: Retrospective, observational, analytical, single-center study in which records of patients undergoing nephrotransplantation for LN were analyzed. They were compared with a group of patients transplanted at the same center for other causes of ESRD.
Results: 41 patients with kidney transplant due to SLE and 89 transplanted due to other causes of ESRD were registered. Graft loss occurred in 12 (29.26%) patients with LN and 34 (38.2%) patients in the comparison group ( p = .428). Only one case (4.8%) presented reactivation of the LN in the graft, without graft loss. Median graft survival was 73.1 months in the LN group and 66.3 months in the comparison group ( p = .221). A total of 8 (19.5%) patients with LN and 11 (12.4%) without LN died ( p = .42), with infections being the main cause in both groups. There were no statistically significant differences between groups in graft and patient survival. In a sub-analysis of 28 patients with LN with aPL study, 4 thrombotic events were observed, in 3 different patients, in the aPL-positive group. There were no statistically significant differences in terms of causes of graft loss and graft survival (positive aFL 75.7 months vs negative aFL 72.7 months, p= .96). There were also no differences in mortality between the groups ( p = .61).
Conclusion: Patients transplanted for LN did not differ from the control population in terms of graft and patient survival. Infections were the main cause of death, so prophylaxis and vaccination continue to be a fundamental pillar in the prevention of infections in immunocompromised patients.

Keywords: Systemic lupus erythematosus; antiphospholipid syndrome; nephritis; renal lupus; thrombosis

Date Created: 20240403 Date Completed: 20240621 Latest Revision: 20240925

20250114

10.1177/09612033241244508

38569651