The outcome of kidney transplantation in lupus patients.

IF 2.3 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology Pub Date : 2025-03-07 DOI:10.1016/j.pedneo.2024.09.008

Ting-Chih Lin, Meng-Kun Tsai, Jyh-Hong Lee, Yao-Hsu Yang, Yu-Tsan Lin, Hsin-Hui Yu, Bor-Luen Chiang, Li-Chieh Wang

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Abstract

Background: Kidney transplantation represents a therapeutic option for individuals with end-stage renal disease due to lupus. However, the influence of lupus activity and immunosuppressive medications on graft survival remains a matter of concern and it has not been thoroughly elucidated.

Methods: In this study, we conducted a retrospective review of 45 lupus patients who underwent kidney transplantation, with the aim of analyzing graft survival and identifying factors influencing the outcome of kidney transplantation in lupus patients.

Results: Graft survival rates at 1, 5, 10, 15, and 20 years were 98%, 98%, 88%, 85%, and 78%, respectively. Univariate logistic regression revealed hypertension, positive panel reactive antibodies against HLA class II antigens, retransplant, young age at lupus nephritis onset, low postoperative C4 levels, and HBsAg and/or anti-HBe antibody presence were significantly correlated with decreased graft survival (p < 0.05). Multiple regression confirmed the significant association of HBsAg and/or anti-HBe antibody with graft failure (p = 0.0161), with all patients testing negative for anti-HBc antibody. Preoperative markers (C3, C4, anti-dsDNA antibody) and recurrent lupus nephritis did not impact graft failure.

Conclusion: In lupus patients undergoing kidney transplantation, hepatitis B serology emerges as a potential singular predictor for graft failure, while preoperative lupus activity markers and recurrent lupus nephritis do not affect outcomes.

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狼疮患者肾移植的结果。

背景：对于狼疮引起的终末期肾病患者，肾移植是一种治疗选择。然而，狼疮活动和免疫抑制药物对移植物存活的影响仍然是一个值得关注的问题，并没有完全阐明。方法：本研究对45例接受肾移植的狼疮患者进行回顾性分析，目的是分析狼疮患者的移植物存活情况，并找出影响狼疮患者肾移植预后的因素。结果：移植1、5、10、15、20年生存率分别为98%、98%、88%、85%、78%。单因素logistic回归显示，高血压、HLAⅱ类抗体阳性、再移植、狼疮性肾炎发病年龄小、术后C4水平低、HBsAg和/或抗hbe抗体存在与移植物存活率降低显著相关(p)。在接受肾移植的狼疮患者中，乙型肝炎血清学成为移植失败的潜在单一预测因子，而术前狼疮活动标志物和复发性狼疮肾炎不影响结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatrics and Neonatology PEDIATRICS-

CiteScore

3.10

自引率

0.00%

发文量

170

审稿时长

48 days

期刊介绍： Pediatrics and Neonatology is the official peer-reviewed publication of the Taiwan Pediatric Association and The Society of Neonatology ROC, and is indexed in EMBASE and SCOPUS. Articles on clinical and laboratory research in pediatrics and related fields are eligible for consideration.