Background: Despite improvements in overall prognosis in lupus nephritis, 10%-30% of patients with proliferative renal involvement progress to end stage renal disease, and kidney transplantation is a great option. The aim is to evaluate the kidney transplant outcome in the patients with lupus nephritis (LN).

Methods:We retrospectively analyzed 2,234 KTRs from January 1980 to February 2016 at Seoul National University Hospital. A total of 28 lupus transplant patients were enrolled in this study, and non-lupus controls were matched 1:4 with lupus transplant patients with respect to age, sex, diabetes, donor type, and year of transplantation. The two groups were compared before and after matching. Recurrent lupus nephritis was diagnosed by light microscopy, immunofluorescence, and electron microscopy.

Results:We included 28 lupus transplant patients and 128 matched controls who were followed for a mean period of 102.9 ± 82.7 and 96.9 ± 80.3 months, respectively, after kidney transplantation (KT). There was no difference in death-censored graft survival and patient survival before and after matching in two groups, however biopsy-proven acute rejection (BPAR)-free survival was increased in LN group after matching (P = 0.023). Age and baseline albumin, acute rejection was associated with death-censored graft loss according to multiple Cox regression analysis after matching (Age: HR = 0.98, 95% CI 0.97-0.99, P= 0.009, albumin: HR = 0.54, 95% CI 0.35-0.82, P = 0.004). And age (per 1 year), baseline estimated glomerular filtration rate (eGFR) and albumin was associated with patient survival (Age: HR = 1.08, 95% CI 1.05-1.11, P < 0.001, eGFR: HR 1.11, 95% CI 1.06-1.15, P < 0.001, albumin: HR 0.47, 95% CI 0.29-0.78, P = 0.003). There was 2 patients who recurred LN after KT, and donors were younger in recurred patients compared with non-recurred patients (43.4 ± 10.8 vs 19.0 ± 2.8, P = 0.006). Sex, deceased donor, dialysis duration and age below 30 was not statistically significant risk factors for recurrence of LN in logistic models.

Conclusions: KT is a reasonable option for ESRD patients with LN. Sex, donor type, dialysis duration and younger age is not seemed to be a risk factor for recurrence of LN in KTRs.

CITATION INFORMATION: Kim Y., Lee H., Chin H., Kim Y., Han S. Kidney Transplant Outcome in the Patients with Lupus Nephritis Am J Transplant. 2017;17 (suppl 3).

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