Evaluation of Renal Grafts in Patients With Lupus Nephritis as Cause of End-Stage Renal Disease
Section snippets
Methods
We studied 20 patients (15 women and five men) with ESRD due to lupus nephritis who received 22 transplants. Their mean age was 34 ± 8 years, time on dialysis before transplantation 21 ± 19 months, and duration of SLE, 9 ± 4 years. The cold ischemia time was 22 ± 4 hours. All the patients received the graft from a cadaveric donor and all received corticosteroids and a primary immunosuppressant (11 patients cyclosporine [CsA] vs 11 patients tacrolimus) plus a secondary immunosuppressant (13
Results
At a mean follow-up of 36 ± 35 months (1 to 120 months), we observed a temporal relation between the secondary immunosuppressant, with a trend toward benefit of MMF. Eight patients suffered delayed graft function (38%), with a mean duration of 9 ± 4 days. Nine grafts were lost: two because of acute rejection; two, venous thrombosis; and five, chronic allograft nephropathy. One patient died of hemorrhagic shock soon after transplantation. There were five cases of cytomegalovirus infection and no
Discussion
Renal transplantation among patients with ESRD caused by lupus nephritis has become an accepted alternative for long-term treatment. The outcome of renal transplantation in patients with systemic lupus erythematosus is still controversial. Infection, recurrent disease, acute and chronic rejection, as well as thrombosis may play a role in early graft loss. Our study showed poorer graft survival among patients with acute rejection episodes and delayed graft function. Several authors, such as
References (7)
Outcomes of renal transplantation among patients with end stage renal disease caused by lupus nephritis
Kidney Int
(2000)- et al.
Outcome of renal transplantation in ninety-seven cyclosporine-era patients with systemic lupus erythematosus and matched controls
Arthritis Rheum
(1998) - et al.
Outcome after transplantation of young patients with systemic lupus erythematosus: a report of the north American pediatric renal transplant cooperative study
Transplantation
(2001)