The Outcome of Kidney Transplantation in Lupus Patients

Abstract Kidney transplantation is one of the treatments for end-stage renal disease in lupus patients. The impact of lupus activity on graft survival is a concern. In this study, we aimed to analyze graft survival and factors affecting outcome of kidney transplantation in 45 lupus patients. The graft survival rate was 98, 98, 88, 85 and 78% at 1, 5, 10, 15 and 20 years, respectively. Hypertension, positive penal reactive antibodies against HLA class 2 antigens, retransplant, younger age of lupus nephritis onset, lower postoperative C4 level and the presence of HBsAg and/or anti-HBe antibody showed significantly negative correlation on graft survival by univariate logistic regression. The only factor that is significantly associated with graft failure after adjusting above factors by multiple regression is the presence of HBsAg and/or anti-HBe antibody (p = .0161). Serological markers for activity including C3, C4 and anti-dsDNA antibody before kidney transplantation and recurrent lupus nephritis were not significantly associated with graft failure. In conclusion, in lupus patients underwent kidney transplantation, preoperative serological markers for lupus activity and recurrent lupus nephritis did not affect the graft outcome. However, hepatitis B virus serology might be a single predictor for graft failure in lupus patients.