Impact of recurrent lupus nephritis on lupus kidney transplantation: a 20-year single center experience.
This study was conducted to delineate the frequency of recurrent lupus nephritis in a Chinese kidney transplant cohort and to estimate its impact on long-term transplant outcomes. A total of 32 lupus transplant patients were enrolled in this study, and the medical records were retrospectively reviewed. Patients with unexplained graft abnormalities were subjected to allograft biopsy. Recurrent lupus nephritis was diagnosed by light microscopy, immunofluorescence, and electron microscopy. In addition, to determine the clinical manifestations of recurrent lupus GN in these patients, serum original systemic lupus erythematosus disease activity index (SLEDAI) scores while undergoing allograft biopsy were evaluated. In total, six out of 32 patients (18.8%; mean age, 40.5 ± 9.1 years) were diagnosed as having recurrent lupus nephritis and the mean time at diagnosis was 5.1 ± 4.9 years post-transplantation. According to the International Society of Nephrology/Renal Pathology Society (ISN/RPS) 2003 criteria, three of the six cases (50%) were defined as class I, one was class II, one was class IV, and one was class III + V. The graft and patient survival rates of recurrent lupus nephritis (n = 6) were not different from those of patients with other diagnostic entities. Although recurrent lupus nephritis was not uncommon, it did not appear to have a strong negative impact on long-term outcome in Chinese kidney transplant patients. The recurrence was potentially treatable and should not be precluded for receiving transplantation.
Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
Tung-Min
TM
Yu
Mie-Chin
MC
Wen
Chi-Yuan
CY
Li
Chi-Huang
CH
Cheng
Ming-Ju
MJ
Wu
Cheng-Hsu
CH
Chen
Yi-Hsing
YH
Chen
Hao-Chung
HC
Ho
Kuo-Hsiung
KH
Shu
D000328:Adult; D044466:Asian People; D005260:Female; D006084:Graft Rejection / Q000401:mortality*; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality*; D008181:Lupus Nephritis / Q000401:mortality / Q000601:surgery*; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies