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Recurrence of lupus nephritis after renal transplantation: if we look for it, will we find it?

Nature Clinical Practice Nephrology volume 1, pages 62–63 (2005)Cite this article

Renal transplantation can be associated with excellent outcomes in patients with end-stage renal disease (ESRD) due to lupus nephritis. Allograft and patient survival in this population seem comparable to allograft and patient survival in transplant recipients with ESRD due to other causes.1,2 Although some studies have reported worse post-transplant outcomes in patients with lupus nephritis,3 most clinicians believe that these individuals fare no differently after transplant than patients without lupus.

Recurrence of lupus nephritis after transplantation is widely regarded as rare,4,5 and typically cited as occurring in 1–4% of cases. These apparently low rates led to widespread use of transplantation among patients with ESRD due to lupus nephritis. Several studies, however, have reported a higher incidence of recurrent lupus nephritis after renal transplantation. In one study of 97 lupus patients who received 106 renal transplants, biopsy-proven recurrence was observed in 9 cases (8.5%).6 Similar rates of recurrence were reported in a study of 48 renal transplants (10.4%)7 and in a more recent analysis of 33 renal transplants (8.5%).8 Of 50 lupus patients with at least 3 months of post-transplant follow-up in another study, 15 (30%) had biopsy-proven recurrence.9 A small investigation of biopsies from 16 lupus patients (8 biopsies were clinically indicated, 8 were elective) found histologic recurrence in 7 patients (43.8%).10

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Authors and Affiliations

  1. an Attending Transplant Nephrologist at Saint Barnabas Medical Center, Livingston, NJ, USA

    Francis Weng

  2. an Associate Professor of Medicine at the University of Pennsylvania Medical Center, Philadelphia, PA, USA

    Simin Goral

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  1. Francis Weng
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  2. Simin Goral
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Correspondence to Simin Goral.

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Weng, F., Goral, S. Recurrence of lupus nephritis after renal transplantation: if we look for it, will we find it?. Nat Rev Nephrol 1, 62–63 (2005). https://doi.org/10.1038/ncpneph0028

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