Renal transplantation is the therapy of choice in patients with end stage lupus nephritis (LN).
To analyze the characteristics and outcomes of renal transplantation in LN patients.
Retrospective, descriptive study in SLE patients (ACR 82-97) who received a renal transplant (RTx). Demographic variables, donor characteristics, post-transplant immunosuppressant treatments, causes of graft loss, deaths and their causes and patient and graft survival were analyzed.
Forty-one patients (90.2% women) were analyzed. The median time from dialysis to transplant was 99.1 months (IQR 59.9-131.7). A 87.8% of the cases received cadaveric renal graft. The most used immunosuppressant treatment was mycophenolate mofetil + tacrolimus + corticoids in 56.1% of the patients. A total of 12/41 (29.2%) of patients experienced graft rejection or failure. The main causes of graft loss were diagnosed as chronic allograft nephropathy (n=8), BK virus infection (n=1), focal and segmental glomerulosclerosis (n=1), renal artery thrombosis (n=1) and acute allograft rejection (n=1). In only two patients (4.8%) the graft extraction was performed and no patients the transplant was performed in a second time. A 4.8% of the cases presented relapsing NL in the graft but without loss it. Eight patients (19.5%) died and the main causes of death were: infectious (n=5), cardiovascular (n=2) and lymphoma (n=1). Patient survival at one, five and ten years was 100%, 87,8% y 80,4%, respectively and the median graft survival was 73 months (IQR: 41.7-122.9).
Patient survival was favorable. One third of the patients with Lupus and kidney transplantation suffered graft loss and 19% died during follow-up