[SA-PO3076] Recurrence of Lupus Nephritis Following Kidney Transplantation

Gabriel Contreras, A. Mattiazzi, G. Guerra, H. Li, L. Tamariz, C. Carvalho, W. Kupin, B. LeClercq, I. Jaraba, D. Carvalho, M. Ladino, D. Roth University of Miami Miller School of Medicine; Private Practice

Introduction: The rate and outcome of recurrent lupus nephritis (RLN) in systemic lupus erythematosus (SLE) recipients of a kidney allograft vary among published reports. Purpose: We estimate the period prevalence of RLN in a population of kidney transplant recipients from the United Network for Organ Sharing files transplanted between 1987 and 2006. The effects of RLN on allograft failure and recipients' survival are assessed along with the factors associated with its occurrence. Methods: Case-control study of 6850 SLE recipients of a kidney allograft: 167 cases with RLN, 1770 controls with rejection and 4913 controls without recurrence or rejection (others group). Results: The period prevalence of RLN was 2.44%. By logistic regression analysis, Black non-Hispanics race-ethnicity (OR [95% CI] 1.71 [1.25 to 2.34]), female gender (1.69 [1.05 to 2.75]), and age < 33 years old (1.39 [1.02 to 1.91]) were independently associated with the development of RLN. 156 (93.4%), 1517 (85.7%) and 923 (19.1%) recipients in the RLN, rejection and others groups respectively lost their allograft. By proportional hazard regression analyses, RLN (HR [95% CI] 4.09 [3.41 to 4.92] vs. others group) was independently associated with increased risk for allograft failure adjusting for rejection and other important covariates. The attributable risk for allograft failure of RLN was 7%. In the study, 27 (16.2%), 313 (17.7%) and 527 (10.7%) recipients in the RLN, rejection and others groups died, respectively (P<0.0001 for trend). Conclusions: Whereas RLN seems uncommon in SLE recipients of a kidney allograft, RLN does however commonly lead to allograft failure with an increased risk for death after transplantation. In this study, the development of RLN can be predicted by the race-ethnicity, gender and age of the recipients.
Work was supported by Health Resources and Services Administration contract 231-00-0115. Content is the responsibility of the authors alone and does not mention commercial products or organization nor necessary reflect the views of the Department of Health and Human Services.

Saturday, October 31, 2009 10:00 AM

Poster Session: Transplantation: Epidemiology, Outcomes, Clinical Trials, and Health Services Research III (10:00 AM-12:00 PM) Poster Board Number: SA-PO3076

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