engleski

Outcome of kidney transplantation in patients with lupus nephritis – a single center experience and review of the literature

Aims: Kidney transplantation (KT) is the treatment of choice for end-stage kidney disease in patients with systemic lupus erythematosus (SLE). Still, these patients tend to fare worse than other patient groups with chronic kidney failure. The main aim of this retrospective observational study was to evaluate the outcomes of KT in patients with SLE. Methods: Data were obtained from medical records and charts. Results: From February 2007, a total of 12 SLE patients, average age 37 (18-56) years, underwent deceased donor KT at our Center. Comorbidities were primarily cardiovascular. At the time of KT, 91.7% of patients showed no signs of SLE activity. Immunological matching was favorable and all allografts showed satisfactory initial function. Median graft survival for the whole patient population was 41 (0-93) months. In 66.7% of patients with stable graft function, median survival was 61 (22-93) months, in three patients longer than fi ve years. One patient died 4 months after the transplantation from neurologic complications, whereas 25% of allografts were lost in the early post- transplant period, in 0-5 months after KT. Our patient outcomes showed no clear correlation between age, previous KT or number of comorbidities. Episodes of acute rejection or recurrent lupus nephritis brought a higher risk of poor outcome. Conclusion: While there still are many unanswered questions relating to the management of this immunologically very sensitive group of patients, forming a multidisciplinary transplantation team would enable pre-transplant evaluation of SLE patients with possible risk assessment and adjustment of follow up strategy to achieve an optimal survival outcome

lupus nephritis ; renal replacement therapy ; kidney transplantation ; outcome

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