title: The long-term prognosis of renal transplantation in patients with lupus nephritis.
abstract: BACKGROUND
  Few data are available about the long-term outcome of renal transplantation in patients with systemic lupus erythematosus (SLE).
  
  
  METHODS
  Between June 1982 and 2004, a total of 33 adults with lupus nephritis received 35 kidney allografts. Outcomes of these grafts and those of 70 controls matched for age, sex, and donor source who underwent transplantation during the same period were compared.
  
  
  RESULTS
  Mean follow-up after renal transplantation was 91 +/- 59 months for patients with lupus and 90 +/- 64 months for controls. Actuarial 15-year patient (80% versus 83%) and death-censored graft survival rates (69% versus 67%) were not significantly different between patients with lupus and controls. Risks for acute and chronic rejection, arterial hypertension, and infection were not different between the 2 groups. Mean serum creatinine levels also were similar in the 2 groups at the last follow-up visit. Intravascular thrombotic events occurred in 9 patients with SLE (26%) and 6 controls (8.6%; P = 0.038). In the SLE group, 6 of 7 antiphospholipid (aPL) antibody-positive versus 3 of 17 aPL antibody-negative patients experienced thrombotic events ( P = 0.015). Recurrence of lupus nephritis was documented in 3 renal grafts (8.6%), but no graft was lost because of recurrent lupus nephritis.
  
  
  CONCLUSIONS
  Long-term patient and graft survival probabilities were similar in patients with SLE and matched controls. The risk for thrombotic complications was greater in patients with SLE, particularly aPL-positive patients. Nephritis recurred in less than 10% of patients with SLE and did not influence graft survival.
authors.affiliation: Divisione di Nefrologia e Dialisi, Centro Trasfusionale e di Immunologia dei Trapianti IRCCS, Ospedale Maggiore Milano, Italy. gmoroni@policlinico.mi.it
authors.forename: Gabriella
authors.initials: G
authors.lastname: Moroni
authors.forename: Francesca
authors.initials: F
authors.lastname: Tantardini
authors.forename: Beniamina
authors.initials: B
authors.lastname: Gallelli
authors.forename: Silvana
authors.initials: S
authors.lastname: Quaglini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Banfi
authors.forename: Francesca
authors.initials: F
authors.lastname: Poli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Montagnino
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Meroni
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Messa
authors.forename: Claudio
authors.initials: C
authors.lastname: Ponticelli
mesh_terms: D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D006085:Graft Survival; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007239:Infections / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D015993:Life Tables; D008181:Lupus Nephritis / Q000188:drug therapy / Q000276:immunology / Q000401:mortality / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012008:Recurrence; D012306:Risk; D019851:Thrombophilia / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D013927:Thrombosis / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D017152:Antibodies, Antiphospholipid; D007166:Immunosuppressive Agents; D003404:Creatinine