Renal Transplantation in Patients With Systemic Lupus Erythematosus

Mejia, Gonzalo; Zimmerman, Stephen W.; Glass, Neal R.; Miller, Douglas T.; Sollinger, Hans W.; Belzer, Folkert O.

doi:10.1001/archinte.1983.00350110067018

Cited by 36 publications

(11 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A large study conducted within the US Renal Data System, in which comparisons were adjusted for confounding factors, reported that both cadaveric and living related-donor graft survival in 1,162 patients with lupus nephritis was equivalent to graft survival in controls [27]. However, other studies have reported poorer graft survival in lupus patients [3,15,16,19,22,261. These conflicting results may be due to differences in composition of the control groups, since only few studies on renal transplantation in lupus patients used matched controls [7,221.…”

Section: Discussionmentioning

confidence: 99%

Outcome of renal transplantation in patients with systemic lupus erythematosus

Deegens¹,

Artz²,

Hoitsma³

et al. 2003

Transplant International

View full text Add to dashboard Cite

Renal transplantation is considered to be a good treatment option for patients with systemic lupus erythematosus (SLE) and end-stage renal disease. However, in patients with glomerular diseases, the outcome of renal transplantation can be adversely affected by recurrence of the original disease. Furthermore, the post-transplant course might be complicated by pretransplant morbidity and treatment history. We studied the outcome of renal transplantation in patients with SLE who underwent transplantations in our center between 1968 and 2001. Patient and graft survival were compared with a matched control group. We specifically looked for any evidence of recurrent disease. There were 23 patients (two male, 21 female) with a mean + SD age of 34 f 12 years at transplantation. One patient developed renal failure with serological evidence of SLE activity at 61 months after transplantation. In the absence of urine abnormalities we favored the diagnosis of rejection, although recurrence of lupus nephritis could not formally be excluded. This was the only case of a possible recurrence of lupus nephritis. Two other patients developed extra-renal manifestations of SLE at 6 and 17 months after transplantation. Patient and graft survival rates at 5 years after transplantation were 86% and 68%, respectively. Survival rates were not significantly different from those of a matched control group, 95% and 78%, respectively. Recurrence of SLE after transplantation is rare. The results of renal transplantation in patients with SLE do not differ significantly from a matched control group. Renal transplantation is a good alternative for renal replacement therapy in patients with lupus nephritis.

show abstract

Section: Discussionmentioning

confidence: 99%

Outcome of renal transplantation in patients with systemic lupus erythematosus

Deegens¹,

Artz²,

Hoitsma³

et al. 2003

Transplant International

View full text Add to dashboard Cite

show abstract

“…Their patients' survival rate was 87% after 5 years of follow-up. A compa rable outcome was also reported by Mejia et al [27], It has been recommended that patients with SLE should have a waiting period on dialysis before receiving a kidney transplant. The recommended length of this dialy sis period has varied from a minimum of 3 months [28] to as long as 1 year [29], Such a waiting period has been required to exclude patients with acute renal failure.…”

Section: Discussionmentioning

confidence: 61%

Renal Transplantation in Systemic Lupus erythematosus: A Single-Center Experience with Sixty-Four Cases

El-Shahawy¹,

Aswad

Méndez

et al. 1995

Am J Nephrol

View full text Add to dashboard Cite

The outcome of renal transplantation in 64 patients with end-stage renal disease (ESRD) secondary to lupus nephritis is the subject of this report. The patients were transplanted over a 150-month (12.5-year) period (between July 5, 1979, and January 30, 1992). The study population is predominantly made up of young females (mean age, 34.7 ± 9 years, n = 54, 81.3%). Fifty-one transplants (79.7%) are cadaveric, and 13 (20.3%) are from living-related donors. Fifty-eight patients (90.6%) had primary (first) allografts, and 6 (9.4%) received a second allograft. Posttransplantation immunosuppression consisted of azathioprine and prednisone (AZA group, n = 22, 34.3%) or AZA, prednisone and cyclosporine (CsA group, n = 42, 65.6%). For all 64 patients combined, the 1-year graft and patient survival rates are 68.8 and 86.5%, respectively, whereas 5-year graft and patient survival rates are 60.9 and 85.9%, respectively. Patients whose immunosuppressive regimen was CsA-based had a 1-year graft survival of 71.5 versus 63.6% in the AZA group. However, this 7.9% difference did not reach statistical significance (p = 0.95). The 5-year graft survival of the CsA-based group was 69.1 versus 45.5% for the AZA group, p < 0.05. One-year patient survival was 77.3% for the AZA group and 92.9% for the CsA group, p < 0.05. The data show that patients with ESRD secondary to lupus nephritis can undergo renal transplantation with satisfactory outcome. Immunosuppression based upon CsA improves first-year patient and allograft survival by 15.6 and 7.9%, respectively. Five-year patient and allograft survival are also increased with CsA therapy, by 16.3 and 23.6%, respectively.

show abstract

“…Systemic lupus erythematosus (SLE) is the cause of renal failure in approximately 5% of patients with ESRD (Table 42) (310,(366)(367)(368)(369)(370)(371)(372)(373)(374)(375)(376)(377). While there are reports of successful transplantation with active SLE (366)(367)(368)372), it is generally recommended that clinical manifestations (renal and extra-renal) be quiescent on minimal doses of corticosteroids, e.g.…”

Section: The Evaluation Of Renal Transplant Candidates: Clinical Pracmentioning

confidence: 99%

“…While there are reports of successful transplantation with active SLE (366)(367)(368)372), it is generally recommended that clinical manifestations (renal and extra-renal) be quiescent on minimal doses of corticosteroids, e.g. no more than 10 mg per day of prednisone, before transplantation.…”

Section: The Evaluation Of Renal Transplant Candidates: Clinical Pracmentioning

confidence: 99%

“…Furthermore, it is suggested that serologic parameters (complement, anti-nuclear antibody, anti-DNA antibody titers) should be normal, or at least stable before transplantation (371), although clinical evidence supporting this recommendation is lacking. Patients can be told that less than 10% of transplant recipients with SLE have recurrence (310,(366)(367)(368)(369)(370)(371)(372)(373)(374)(375)(376)(377). Clinical presentation may be extra-renal (rash, arthralgias, Raynaud's phenomenon) or renal (proteinuria, graft dysfunction).…”

Section: The Evaluation Of Renal Transplant Candidates: Clinical Pracmentioning

confidence: 99%

See 1 more Smart Citation

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

2001

American Journal of Transplantation

View full text Add to dashboard Cite

Renal Transplantation in Patients With Systemic Lupus Erythematosus

Cited by 36 publications

References 12 publications

Outcome of renal transplantation in patients with systemic lupus erythematosus

Outcome of renal transplantation in patients with systemic lupus erythematosus

Renal Transplantation in Systemic Lupus erythematosus: A Single-Center Experience with Sixty-Four Cases

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

Contact Info

Product

Resources

About