BACKGROUND: Renal transplantation is considered a safe procedure for patients with systemic lupus erythematosus (SLE). However, the recurrence of disease and its impact on graft survival remains controversial. METHODS: To analyze the presence of lupus serology activity during dialysis and its impact on lupus recurrence after transplantation, we performed a retrospective analysis of 23 lupus patients who received 26 kidney transplantations. RESULTS: Twenty-three patients received 26 renal transplantations from 1984 to 2003. Twelve patients presented pretransplant lupus activity (low complement and ANA > 1/40), without correlation with length of dialysis, but associated with proliferative glomerulonephritis (class IV) pretransplant. Among 26 grafts, 6 were lost in the first 6 months posttransplant. Among the remaining 20 functioning grafts, low complement activity occurred in 8, being associated with recurrence of immune deposits in 3 cases. Analysis of lupus activity showed that only one patient with a normal complement level posttransplant presented SLEDAI > 4, associated with persistent proteinuria and a graft biopsy without immune deposits. Graft survival was reduced in the presence of low complement posttransplantation. CONCLUSION: Low complement levels after renal transplantation, in association with proteinuria may be considered to be a risk factor for recurrence of immune deposits, with a negative impact on graft survival.
BACKGROUND: Renal transplantation is considered a safe procedure for patients with systemic lupus erythematosus (SLE). However, the recurrence of disease and its impact on graft survival remains controversial. METHODS: To analyze the presence of lupus serology activity during dialysis and its impact on lupus recurrence after transplantation, we performed a retrospective analysis of 23 lupus patients who received 26 kidney transplantations. RESULTS: Twenty-three patients received 26 renal transplantations from 1984 to 2003. Twelve patients presented pretransplant lupus activity (low complement and ANA > 1/40), without correlation with length of dialysis, but associated with proliferative glomerulonephritis (class IV) pretransplant. Among 26 grafts, 6 were lost in the first 6 months posttransplant. Among the remaining 20 functioning grafts, low complement activity occurred in 8, being associated with recurrence of immune deposits in 3 cases. Analysis of lupus activity showed that only one patient with a normal complement level posttransplant presented SLEDAI > 4, associated with persistent proteinuria and a graft biopsy without immune deposits. Graft survival was reduced in the presence of low complement posttransplantation. CONCLUSION: Low complement levels after renal transplantation, in association with proteinuria may be considered to be a risk factor for recurrence of immune deposits, with a negative impact on graft survival.
Authors: Jorge Mario López-Morales; Lauro Quintanilla-González; Juan Carlos Ramírez-Sandoval; Andrea Hinojosa-Azaola Journal: Rheumatol Int Date: 2019-01-02 Impact factor: 2.631
Authors: George K Bertsias; Maria Tektonidou; Zahir Amoura; Martin Aringer; Ingeborg Bajema; Jo H M Berden; John Boletis; Ricard Cervera; Thomas Dörner; Andrea Doria; Franco Ferrario; Jürgen Floege; Frederic A Houssiau; John P A Ioannidis; David A Isenberg; Cees G M Kallenberg; Liz Lightstone; Stephen D Marks; Alberto Martini; Gabriela Moroni; Irmgard Neumann; Manuel Praga; Matthias Schneider; Argyre Starra; Vladimir Tesar; Carlos Vasconcelos; Ronald F van Vollenhoven; Helena Zakharova; Marion Haubitz; Caroline Gordon; David Jayne; Dimitrios T Boumpas Journal: Ann Rheum Dis Date: 2012-07-31 Impact factor: 19.103