Master's Degree in Medical Sciences, Postgraduate Program, University of Fortaleza (Unifor), Fortaleza, Brazil.
Medical student at the University of Fortaleza (Unifor), Fortaleza, Brazil.
Sci Rep. 2019 Aug 12;9(1):11611. doi: 10.1038/s41598-019-48070-y.
This stydy aimed to evaluate the epidemiological and clinical profile and outcome of patients with lupus nephritis (LN) submitted to renal transplantation. Retrospective cohort study based on the records of 35 LN patients submitted to renal transplantation at a single center in Brazil between July 1996 and May 2016. The Kaplan-Meier method was used to estimate 6-month, 1-year and 5-year graft survival. The sample included 38 transplantations (3 of which retransplantations). The mean age at the time of SLE diagnosis was 23.7 ± 9.0 years. Most patients were female (94.7%) and 68.4% were non-Caucasian. Twenty-two (57.9%) underwent renal biopsy prior to transplantation. The mean time from SLE diagnosis to transplantation was 10.3 ± 6.4 years. The mean pre-transplantation dialysis time was 3.8 ± 3.7 years. The grafts came from living related (n = 11) or deceased (n = 27) donors. Three (7.9%) patients experienced acute rejection in the first year. Graft and patient survival rates were, respectively, 97.1% and 100% at 6 months, 84.9% and 96.9% at 1 year, and 76.3% and 92.5% at 5 years. One (2.6%) patient had SLE recurrence. Venous thrombosis (p = 0.017) and antiphospholipid syndrome (APS) (p = 0.036) were more prevalent in patients with graft loss. In our cohort of LN patients submitted to renal transplantation, the 5-year survival rate was high, and APS was an important predictor of poor renal outcome (graft loss).
本研究旨在评估接受肾移植的狼疮肾炎(LN)患者的流行病学和临床特征及结局。这是一项回顾性队列研究,纳入了 1996 年 7 月至 2016 年 5 月在巴西一家中心接受肾移植的 35 例 LN 患者的病历资料。采用 Kaplan-Meier 法估计 6 个月、1 年和 5 年的移植物存活率。该样本包括 38 例移植(其中 3 例为再次移植)。SLE 诊断时的平均年龄为 23.7±9.0 岁。大多数患者为女性(94.7%),68.4%为非白种人。22 例(57.9%)在移植前接受了肾活检。从 SLE 诊断到移植的平均时间为 10.3±6.4 年。移植前平均透析时间为 3.8±3.7 年。移植物来自亲属(n=11)或已故供体(n=27)。3 例(7.9%)患者在第 1 年内发生急性排斥反应。6 个月时,移植物和患者的存活率分别为 97.1%和 100%,1 年时分别为 84.9%和 96.9%,5 年时分别为 76.3%和 92.5%。1 例(2.6%)患者出现狼疮复发。静脉血栓形成(p=0.017)和抗磷脂综合征(APS)(p=0.036)在移植物丢失患者中更为常见。在我们的 LN 患者肾移植队列中,5 年生存率较高,APS 是不良肾脏结局(移植物丢失)的重要预测因素。