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Early outcomes in kidney transplant recipients with systemic lupus erythematosus

Rheumatology International volume 39, pages 479–487 (2019)Cite this article

Abstract

Kidney transplant (KT) is the best treatment for patients who progress to end-stage renal disease. Short-term outcomes in patients with systemic lupus erythematosus (SLE) following KT are not well known. To describe the postoperative outcomes and complications in SLE patients undergoing KT, we conducted a case–control study from 2010 to 2015 including SLE recipients compared to non-SLE controls matched by age and sex. Demographics, comorbidities, donor characteristics, and preoperative tests were retrieved. Main outcomes were 30-day postoperative allograft function, development of infectious or non-infectious complications, and mortality. 68 patients (34 SLE, 34 non-SLE) were included. SLE recipients had median disease duration of 9 years; SLEDAI-2K of 2, and SLICC/ACR damage index of 3; 16 (47%) were taking prednisone (median dose 5 mg daily) before KT. SLE recipients had a lower frequency of diabetes (0 vs. 27%, p = 0.002). No differences were found in the development of any complication (50% SLE vs. 47% non-SLE, p = 1.00); infectious (44% vs. 41%, p = 1.00), or non-infectious (15% vs. 21%, p = 1.00). There were no deaths in either group, and none of the SLE recipients presented lupus disease activity 30 days after the KT. Allograft function determined by serum creatinine, estimated glomerular filtration rate, delayed graft function, and allograft loss was similar in both groups (p > 0.05). There were no differences between SLE recipients with and without complications. Early postoperative outcomes in SLE patients who undergo KT, including allograft function, development of infectious, non-infectious complications, and mortality, are similar to patients without SLE.

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The authors declare that this work was not supported by any grant or funding.

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Affiliations

  1. Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Col. Sección XVI, Tlalpan, CP 14000, Mexico City, Mexico

    Jorge Mario López-Morales, Lauro Quintanilla-González & Andrea Hinojosa-Azaola

  2. Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

    Juan Carlos Ramírez-Sandoval

Authors
  1. Jorge Mario López-Morales
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  2. Lauro Quintanilla-González
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  3. Juan Carlos Ramírez-Sandoval
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  4. Andrea Hinojosa-Azaola
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Contributions

JMLM, LQG and AHA designed the study; JMLM and LQG participated in acquisition of data: AHA and JCRS analyzed and interpreted data; JMLM, LQG, AHA and JCRS drafted the manuscript; JMLM, LQG, AHA and JCRS revised the manuscript.

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Correspondence to Andrea Hinojosa-Azaola.

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López-Morales, J.M., Quintanilla-González, L., Ramírez-Sandoval, J.C. et al. Early outcomes in kidney transplant recipients with systemic lupus erythematosus. Rheumatol Int 39, 479–487 (2019). https://doi.org/10.1007/s00296-018-4234-7

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  • DOI: https://doi.org/10.1007/s00296-018-4234-7

Keywords

  • Allografts
  • Delayed graft function
  • Kidney transplantation
  • Lupus nephritis
  • Postoperative complications