Renal Transplantation in Systemic Lupus Erythematosus: Comparison of Graft Survival With Other Causes of End-stage Renal Disease

Abstract Introduction End-stage renal disease (ESRD) due to lupus nephritis (LN) occurs in 10%–30% of patients. Initially systemic lupus erythematosus (SLE) was a contraindication for kidney transplantation (KT). Today, long-term graft survival remains controversial. Our objective was to compare the survival after KT in patients with SLE or other causes of ESRD. Methods All SLE patients who had undergone KT in a retrospective cohort were included. Renal graft survival was compared with that of 50 controls, matched for age, sex, and year of transplantation. Survival was evaluated by the Kaplan–Meier test and the Cox proportional hazards model. Results Twenty-five subjects with SLE were included. The estimated 1-year, 2- and 5-year survival rates for patients with SLE were 92%, 66% and 66%. Renal graft survival did not differ between patients with SLE and other causes of ESRD ( P  = .39). The multivariate analysis showed no significant difference in graft survival between the two groups (hazard ratio, HR = 1.95, 95% confidence interval [CI] 0.57–6.61, P  = .28). The recurrence rate of LN was 8% and was not associated with graft loss. Acute rejection was the only variable associated with graft loss in patients with SLE (HR = 16.5, 95% CI 1.94–140.1, P  = .01). Conclusions Renal graft survival in SLE patients did not differ from that reported for other causes of ESRD.