title: Renal transplantation in systemic lupus erythematosus: outcome and prognostic factors in 50 cases from a single centre.
abstract: BACKGROUND
  End-stage renal disease (ESRD) is an important cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE).
  
  
  OBJECTIVE
  To analyze the outcome and prognostic factors of renal transplantation in patients with ESRD due to SLE from January 1986 to December 2013 in a single center.
  
  
  RESULTS
  Fifty renal transplantations were performed in 40 SLE patients (32 female (80%), mean age at transplantation 36±10.4 years). The most frequent lupus nephropathy was type IV (72.2%). Graft failure occurred in a total of 15 (30%) transplantations and the causes of graft failure were chronic allograft nephropathy (n=12), acute rejection (n=2), and chronic humoral rejection (1). The death-censored graft survival rates were 93.9% at 1 year, 81.5% at 5 years, and 67.6% at the end of study. The presence of deceased donor allograft (P=0.007) and positive anti-HCV antibodies (P=0.001) negatively influence the survival of the renal transplant. The patient survival rate was 91.4% at the end of the study. Recurrence of lupus nephritis in renal allograft was observed in one patient.
  
  
  CONCLUSIONS
  Renal transplantation is a good alternative for renal replacement therapy in patients with SLE. In our cohort, the presence of anti-HCV antibodies and the type of donor source were related to the development of graft failure.
authors.affiliation: Department of Autoimmune Diseases, Hospital Clínic, Villarroel 170, 08036 Barcelona, Catalonia, Spain ; Unidad de Enfermedades Autoinmunes Sistémicas, Clínica Médica "C", Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Cairoli
authors.affiliation: Department of Autoimmune Diseases, Hospital Clínic, Villarroel 170, 08036 Barcelona, Catalonia, Spain.
authors.forename: Carolina
authors.initials: C
authors.lastname: Sanchez-Marcos
authors.affiliation: Department of Autoimmune Diseases, Hospital Clínic, Villarroel 170, 08036 Barcelona, Catalonia, Spain.
authors.forename: Gerard
authors.initials: G
authors.lastname: Espinosa
authors.affiliation: Department of Nephrology and Renal Transplantation, Hospital Clínic, Barcelona, Catalonia, Spain.
authors.forename: Constanza
authors.initials: C
authors.lastname: Glucksmann
authors.affiliation: Department of Immunology, Hospital Clínic, Barcelona, Catalonia, Spain.
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Ercilla
authors.affiliation: Department of Nephrology and Renal Transplantation, Hospital Clínic, Barcelona, Catalonia, Spain.
authors.forename: Federico
authors.initials: F
authors.lastname: Oppenheimer
authors.affiliation: Department of Autoimmune Diseases, Hospital Clínic, Villarroel 170, 08036 Barcelona, Catalonia, Spain.
authors.forename: Ricard
authors.initials: R
authors.lastname: Cervera
mesh_terms: D000328:Adult; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000401:mortality; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome