Renal transplantation in patients with systemic lupus erythematosus1

A total of 23 renal transplants were performed in 18 patients with systemic lupus erythematosus (SLE) between 1974–1990. Posttransplantation, these patients were followed up for a mean period of 45.1 months (1–180). There were 14 graft losses including 2 patients who died with functioning grafts. Patient and graft survival were calculated by life table analysis. Patient survival at 1,5 and 10 years was 94.2%. 94.2% and 75.3%: and the corresponding graft survival was 61.2%, 50.9%, and 36.3% respectively. There was no significant difference between blacks vs whites, live vs cadaver donors, but there was significantly lower survival in retransplants vs first transplants (p = 0.010). Six grafts were lost within 6 months after transplantation: elevated panel‐reactive antibody (PRA) level (>20%) was the only significant factor for early graft loss (p<0.05). The timing of transplantation and presence of an auto‐antibody did not significantly impact on early graft loss. The graft survival between SLE, diabetes and the remaining end‐stage renal disease (ESRD) patients transplanted between 1980–1990 were calculated using a statistical analytical software; this revealed that the homogenicity of the survival curves between these groups was not significantly different (p = 0.1730). although patients with SLE had poorer outcomes than the other patient groups.