The long-term prognosis of renal transplantation in patients with lupus nephritis

Gabriella Moroni, Francesca Tantardini, Beniamina Gallelli, Silvana Quaglini, Giovanni Banfi, Francesca Poli, Giuseppe Montagnino, Pierluigi Meroni, Piergiorgio Messa, Claudio Ponticelli

Research output: Contribution to journalArticle

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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. Conclusion: 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.

Original languageEnglish
Pages (from-to)903-911
Number of pages9
JournalAmerican Journal of Kidney Diseases
Volume45
Issue number5
DOIs
Publication statusPublished - May 2005

Fingerprint

Lupus Nephritis
Kidney Transplantation
Systemic Lupus Erythematosus
Graft Survival
Antiphospholipid Antibodies
Transplants
Kidney
Nephritis
Allografts
Creatinine
Survival Rate
Transplantation
Tissue Donors
Hypertension

Keywords

  • Lupus nephritis
  • Renal transplantation
  • Systemic lupus erythematosus (SLE)

ASJC Scopus subject areas

  • Nephrology

Cite this

Moroni, G., Tantardini, F., Gallelli, B., Quaglini, S., Banfi, G., Poli, F., ... Ponticelli, C. (2005). The long-term prognosis of renal transplantation in patients with lupus nephritis. American Journal of Kidney Diseases, 45(5), 903-911. https://doi.org/10.1053/j.ajkd.2005.01.038

The long-term prognosis of renal transplantation in patients with lupus nephritis. / Moroni, Gabriella; Tantardini, Francesca; Gallelli, Beniamina; Quaglini, Silvana; Banfi, Giovanni; Poli, Francesca; Montagnino, Giuseppe; Meroni, Pierluigi; Messa, Piergiorgio; Ponticelli, Claudio.

In: American Journal of Kidney Diseases, Vol. 45, No. 5, 05.2005, p. 903-911.

Research output: Contribution to journalArticle

Moroni, G, Tantardini, F, Gallelli, B, Quaglini, S, Banfi, G, Poli, F, Montagnino, G, Meroni, P, Messa, P & Ponticelli, C 2005, 'The long-term prognosis of renal transplantation in patients with lupus nephritis', American Journal of Kidney Diseases, vol. 45, no. 5, pp. 903-911. https://doi.org/10.1053/j.ajkd.2005.01.038
Moroni, Gabriella ; Tantardini, Francesca ; Gallelli, Beniamina ; Quaglini, Silvana ; Banfi, Giovanni ; Poli, Francesca ; Montagnino, Giuseppe ; Meroni, Pierluigi ; Messa, Piergiorgio ; Ponticelli, Claudio. / The long-term prognosis of renal transplantation in patients with lupus nephritis. In: American Journal of Kidney Diseases. 2005 ; Vol. 45, No. 5. pp. 903-911.
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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. Conclusion: 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.",
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AU - Moroni, Gabriella

AU - Tantardini, Francesca

AU - Gallelli, Beniamina

AU - Quaglini, Silvana

AU - Banfi, Giovanni

AU - Poli, Francesca

AU - Montagnino, Giuseppe

AU - Meroni, Pierluigi

AU - Messa, Piergiorgio

AU - Ponticelli, Claudio

PY - 2005/5

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N2 - • 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. Conclusion: 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.

AB - • 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. Conclusion: 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.

KW - Lupus nephritis

KW - Renal transplantation

KW - Systemic lupus erythematosus (SLE)

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