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.
Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Rheumatol Int. 2019 Mar;39(3):479-487. doi: 10.1007/s00296-018-4234-7. Epub 2019 Jan 2.
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.
肾移植（KT）是进展至终末期肾病患者的最佳治疗方法。系统性红斑狼疮（SLE）患者接受 KT 后的短期结局尚不清楚。为了描述 SLE 患者接受 KT 后的术后结局和并发症，我们进行了一项病例对照研究，该研究纳入了 2010 年至 2015 年期间的 SLE 患者和非 SLE 患者，这些患者按年龄和性别进行匹配。我们检索了患者的人口统计学资料、合并症、供者特征和术前检查。主要结局为术后 30 天移植物功能、感染性或非感染性并发症的发生以及死亡率。共纳入 68 例患者（34 例 SLE，34 例非 SLE）。SLE 患者的中位疾病持续时间为 9 年；SLEDAI-2K 评分为 2 分，SLICC/ACR 损害指数为 3 分；16 例（47%）在接受 KT 前服用泼尼松（中位剂量为 5mg/d）。SLE 患者糖尿病发生率较低（0% vs. 27%，p=0.002）。两组患者任何并发症的发生率均无差异（SLE 组 50% vs. 非 SLE 组 47%，p=1.00）；感染性并发症（44% vs. 41%，p=1.00）和非感染性并发症（15% vs. 21%，p=1.00）。两组均无死亡病例，且 SLE 患者在 KT 后 30 天均无狼疮活动。两组患者血清肌酐、估计肾小球滤过率、延迟移植物功能和移植物丢失所确定的移植物功能相似（p>0.05）。有并发症和无并发症的 SLE 患者之间无差异。SLE 患者接受 KT 后的早期术后结局，包括移植物功能、感染性、非感染性并发症的发生和死亡率，与无 SLE 的患者相似。
