Risk factors and impact of recurrent lupus nephritis in patients with systemic lupus erythematosus undergoing renal transplantation: Data from a single US institution

Burgos, Paula I.; Perkins, Elizabeth; Pons-Estel, Guillermo J.; Kendrick, Scott A.; Liu, Jigna M.; Kendrick, W.; Cook, William J.; Julian, Bruce A.; Alarcón, Graciela S.; Kew, Clifton E.

doi:10.1002/art.24776

Cited by 68 publications

(92 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Also, recipients who were younger than 33 years had 1.69-fold increased odds for development of RLN. In agreement with the study by Burgos et al, 24 black non-Hispanic race was the strongest predictor of the development of RLN. Onset of SLE at a younger age in an black woman usually predicts a more aggressive form of this disease that can be prone to recurrence 34,35 at anytime after transplantation.…”

Section: Discussionsupporting

confidence: 92%

“…This finding agrees with Burgos et al 24 and our own center's experience but contrasts with Goral et al, 27 who reported that allograft failure as a consequence of RLN was rare. In the study by Goral et al, 53% of the recipients with RLN had WHO class II lesions.…”

Section: Discussionsupporting

confidence: 92%

“…24,[27][28][29][30][31] In this case-control study, we estimated the period prevalence of RLN in kidney transplant recipients who had ESRD secondary to lupus nephritis and received a transplant between October 1987 and October 2006. We assessed the effects of RLN on graft failure and recipient survival and the risk factors leading to the development of RLN.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Recurrence of Lupus Nephritis after Kidney Transplantation

Contreras¹,

Mattiazzi²,

Guerra³

et al. 2010

Journal of the American Society of Nephrology

117

118

View full text Add to dashboard Cite

The frequency and outcome of recurrent lupus nephritis (RLN) among recipients of a kidney allograft vary among single-center reports. From the United Network for Organ Sharing files, we estimated the period prevalence and predictors of RLN in recipients who received a transplant between 1987 and 2006 and assessed the effects of RLN on allograft failure and recipients' survival. Among 6850 recipients of a kidney allograft with systemic lupus erythematosus, 167 recipients had RLN, 1770 experienced rejection, and 4913 control subjects did not experience rejection. The period prevalence of RLN was 2.44%. Non-Hispanic black race, female gender, and age Ͻ33 years each independently increased the odds of RLN. Graft failure occurred in 156 (93%) of those with RLN, 1517 (86%) of those with rejection, and 923 (19%) of control subjects without rejection. Although recipients with RLN had a fourfold greater risk for graft failure compared with control subjects without rejection, only 7% of graft failure episodes were attributable to RLN compared and 43% to rejection. During follow-up, 867 (13%) recipients died: 27 (16%) in the RLN group, 313 (18%) in the rejection group, and 527 (11%) in the control group. In summary, severe RLN is uncommon in recipients of a kidney allograft, but black recipients, female recipient, and younger recipients are at increased risk. Although RLN significantly increases the risk for graft failure, it contributes far less than rejection to its overall incidence; therefore, these findings should not keep patients with lupus from seeking a kidney transplant.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Recurrence of Lupus Nephritis after Kidney Transplantation

Contreras¹,

Mattiazzi²,

Guerra³

et al. 2010

Journal of the American Society of Nephrology

117

118

View full text Add to dashboard Cite

show abstract

“…An additional group of investigators pointed out that the risk of recurrence was even higher, when diligently searched for, ranging between 30 and 54% (14 -16). A number of reasons may account for these discrepancies: (1) The indication for renal allograft biopsy varies among transplant units; (2) some studies reported the results seen in single centers whereas others collected data through national or multinational registries; (3) the follow-up was short in many studies-an important point because recurrences may occur more than a decade after transplantation (11,17); (4) the risk of recurrence may vary in different ancestral groups (10,18); (5) a diagnosis of recurrence of LN requires a graft biopsy examined by light microscopy, immunofluorescence, and electron microscopy, which were not always routinely performed (19).…”

Section: Lupus Nephritismentioning

confidence: 99%

Recurrence of Secondary Glomerular Disease after Renal Transplantation

Ponticelli¹,

Moroni

Glassock

2011

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryThe risk of a posttransplant recurrence of secondary glomerulonephritis (GN) is quite variable. Histologic recurrence is frequent in lupus nephritis, but the lesions are rarely severe and usually do not impair the longterm graft outcome. Patients with Henoch-Schonlein nephritis have graft survival similar to that of other renal diseases, although recurrent Henoch-Schonlein nephritis with extensive crescents has a poor prognosis. Amyloid light-chain amyloidosis recurs frequently in renal allografts but it rarely causes graft failure. Amyloidosis secondary to chronic inflammation may also recur, but this is extremely rare in patients with Behcet's disease or in those with familial Mediterranean fever, when the latter are treated with colchicine. Double organ transplantation (liver/kidney; heart/kidney), chemotherapy, and autologous stem cell transplantation may be considered in particular cases of amyloidosis, such as hereditary amyloidosis or multiple myeloma. There is little experience with renal transplantation in light-chain deposition disease, fibrillary/ immunotactoid GN, or mixed cryoglobulinemic nephritis but successful cases have been reported. Diabetic nephropathy often recurs but usually only after many years. Recurrence in patients with small vessel vasculitis is unpredictable but can cause graft failure. However, in spite of recurrence, patient and graft survival rates are similar in patients with small vessel vasculitis compared with those with other renal diseases. Many secondary forms of GN no longer represent a potential contraindication to renal transplantation. The main issues in transplantation of patients with secondary GN are the infectious, cardiovascular, or hepatic complications associated with the original disease or its treatment.

show abstract

“…[3][4][5] In addition, the reported recurrence rate of LN after transplantation varies in different series. [6][7][8] The longterm prognosis of renal transplant recipients with SLE is still controversial and few studies report results at 10 years or more. 4,6,9,10 The aim of this study was to analyze the longterm outcome of patients with LN who underwent renal transplantation from a single Brazilian center.…”

Section: Introductionmentioning

confidence: 99%

Outcomes in renal transplant recipients with lupus nephritis: experience at a single center

et al. 2014

View full text Add to dashboard Cite

Background: The long-term prognosis of renal transplant recipients with systemic lupus erythematosus is still controversial. The outcome of these patients depends on the population studied, race/ethnicity, socioeconomic conditions, donor-related factors and recurrent lupus nephritis (LN), among other factors. Objective: This study was conducted to evaluate kidney transplantation outcomes for adult Brazilian patients with LN at a single center. Subjects and method: The archival records of all patients with LN who had received a kidney transplant at Santa Casa of Sao Paulo Hospítal were reviewed. Kaplan-Meier method was used to determine the survival rate. Results: We identified 18 patients with LN subjected to 22 kidney transplants during the 20-year interval. Two patients received three renal grafts. The majority of the patients were female, with 33.7 ± 10 years at the time of the transplantation, and half of them were African descendants or mixed. Sixteen transplants were performed from deceased donors and six from living-related donors. The patient survival rate was 90%, and graft survival was 68% at 10 years. Chronic allograft nephropathy was the major cause of graft loss. Two patients developed extra-renal manifestations of lupus. There was no clinical or histological evidence of recurrent LN. Conclusion: Renal transplantation is a method which can provide a long-term survival for patients with SLE and end-stage renal disease.

show abstract

Risk factors and impact of recurrent lupus nephritis in patients with systemic lupus erythematosus undergoing renal transplantation: Data from a single US institution

Cited by 68 publications

References 42 publications

Recurrence of Lupus Nephritis after Kidney Transplantation

Recurrence of Lupus Nephritis after Kidney Transplantation

Recurrence of Secondary Glomerular Disease after Renal Transplantation

Outcomes in renal transplant recipients with lupus nephritis: experience at a single center

Contact Info

Product

Resources

About