Systemic Lupus Erythematosus After Renal Transplantation: Is Complement a Good Marker for Graft Survival?

Abstract Background Renal transplantation is considered a safe procedure for patients with systemic lupus erythematosus (SLE). However, the recurrence of disease and its impact on graft survival remains controversial. Methods To analyze the presence of lupus serology activity during dialysis and its...

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Veröffentlicht in:Transplantation proceedings 2008-04, Vol.40 (3), p.746-748
Hauptverfasser: Signori Baracat, A.L, Ribeiro-Alves, M.A.V.F, Alves-Filho, G, Mazzali, M
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container_issue 3
container_start_page 746
container_title Transplantation proceedings
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creator Signori Baracat, A.L
Ribeiro-Alves, M.A.V.F
Alves-Filho, G
Mazzali, M
description Abstract Background Renal transplantation is considered a safe procedure for patients with systemic lupus erythematosus (SLE). However, the recurrence of disease and its impact on graft survival remains controversial. Methods To analyze the presence of lupus serology activity during dialysis and its impact on lupus recurrence after transplantation, we performed a retrospective analysis of 23 lupus patients who received 26 kidney transplantations. Results Twenty-three patients received 26 renal transplantations from 1984 to 2003. Twelve patients presented pretransplant lupus activity (low complement and ANA > 1/40), without correlation with length of dialysis, but associated with proliferative glomerulonephritis (class IV) pretransplant. Among 26 grafts, 6 were lost in the first 6 months posttransplant. Among the remaining 20 functioning grafts, low complement activity occurred in 8, being associated with recurrence of immune deposits in 3 cases. Analysis of lupus activity showed that only one patient with a normal complement level posttransplant presented SLEDAI > 4, associated with persistent proteinuria and a graft biopsy without immune deposits. Graft survival was reduced in the presence of low complement posttransplantation. Conclusion Low complement levels after renal transplantation, in association with proteinuria may be considered to be a risk factor for recurrence of immune deposits, with a negative impact on graft survival.
doi_str_mv 10.1016/j.transproceed.2008.02.045
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However, the recurrence of disease and its impact on graft survival remains controversial. Methods To analyze the presence of lupus serology activity during dialysis and its impact on lupus recurrence after transplantation, we performed a retrospective analysis of 23 lupus patients who received 26 kidney transplantations. Results Twenty-three patients received 26 renal transplantations from 1984 to 2003. Twelve patients presented pretransplant lupus activity (low complement and ANA &gt; 1/40), without correlation with length of dialysis, but associated with proliferative glomerulonephritis (class IV) pretransplant. Among 26 grafts, 6 were lost in the first 6 months posttransplant. Among the remaining 20 functioning grafts, low complement activity occurred in 8, being associated with recurrence of immune deposits in 3 cases. Analysis of lupus activity showed that only one patient with a normal complement level posttransplant presented SLEDAI &gt; 4, associated with persistent proteinuria and a graft biopsy without immune deposits. Graft survival was reduced in the presence of low complement posttransplantation. Conclusion Low complement levels after renal transplantation, in association with proteinuria may be considered to be a risk factor for recurrence of immune deposits, with a negative impact on graft survival.</description><identifier>ISSN: 0041-1345</identifier><identifier>EISSN: 1873-2623</identifier><identifier>DOI: 10.1016/j.transproceed.2008.02.045</identifier><identifier>PMID: 18455005</identifier><identifier>CODEN: TRPPA8</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Biological and medical sciences ; Biomarkers - blood ; Complement System Proteins - metabolism ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Graft Survival - physiology ; Humans ; Kidney Failure, Chronic - surgery ; Kidney Transplantation - adverse effects ; Kidney Transplantation - physiology ; Lupus Erythematosus, Systemic - epidemiology ; Medical sciences ; Postoperative Complications - epidemiology ; Recurrence ; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. 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However, the recurrence of disease and its impact on graft survival remains controversial. Methods To analyze the presence of lupus serology activity during dialysis and its impact on lupus recurrence after transplantation, we performed a retrospective analysis of 23 lupus patients who received 26 kidney transplantations. Results Twenty-three patients received 26 renal transplantations from 1984 to 2003. Twelve patients presented pretransplant lupus activity (low complement and ANA &gt; 1/40), without correlation with length of dialysis, but associated with proliferative glomerulonephritis (class IV) pretransplant. Among 26 grafts, 6 were lost in the first 6 months posttransplant. Among the remaining 20 functioning grafts, low complement activity occurred in 8, being associated with recurrence of immune deposits in 3 cases. Analysis of lupus activity showed that only one patient with a normal complement level posttransplant presented SLEDAI &gt; 4, associated with persistent proteinuria and a graft biopsy without immune deposits. Graft survival was reduced in the presence of low complement posttransplantation. Conclusion Low complement levels after renal transplantation, in association with proteinuria may be considered to be a risk factor for recurrence of immune deposits, with a negative impact on graft survival.</description><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Complement System Proteins - metabolism</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Graft Survival - physiology</subject><subject>Humans</subject><subject>Kidney Failure, Chronic - surgery</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Kidney Transplantation - physiology</subject><subject>Lupus Erythematosus, Systemic - epidemiology</subject><subject>Medical sciences</subject><subject>Postoperative Complications - epidemiology</subject><subject>Recurrence</subject><subject>Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>Time Factors</subject><subject>Tissue, organ and graft immunology</subject><issn>0041-1345</issn><issn>1873-2623</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkl2LEzEUhoMobl39CxIEvZt6kknmYy-Upe7WhYpg1-uQJmcw3ZlJTTKF_nvTbVnEK6_CIc97zuFJCHnHYM6AVR-38xT0GHfBG0Q75wDNHPgchHxGZqypy4JXvHxOZgCCFawU8oK8inELueaifEkuWCOkBJAz4taHmHBwhq6m3RTpTTikXzjo5GOurruEgf7AUff0_nFmr8ekk_PjFb2LdOGHXY8DjolquvTe0m86PORI5wNdBt0lup7C3u11__k1edHpPuKb83lJft7e3C--Fqvvy7vF9aowkrep4MJys2Gys1rKWrRVY7gpK6htzVvRoqw7aUyDjBkrOt1C3Qre8o21YCqLorwkH059s5_fE8akBhcN9nlz9FNUVcvqpqraDF6dQBN8jAE7tQtu0OGgGKijaLVVf4tWR9EKuMqic_jtecq0GfLdU_RsNgPvz4CORvddbmRcfOI4lI2oSpa5LycOs5O9w6CicTgatC6gScp693_7fPqnjend6PLkBzxg3Pop5EeMiqmYA2p9_BrHnwENAJOClX8A4Du4yg</recordid><startdate>20080401</startdate><enddate>20080401</enddate><creator>Signori Baracat, A.L</creator><creator>Ribeiro-Alves, M.A.V.F</creator><creator>Alves-Filho, G</creator><creator>Mazzali, M</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20080401</creationdate><title>Systemic Lupus Erythematosus After Renal Transplantation: Is Complement a Good Marker for Graft Survival?</title><author>Signori Baracat, A.L ; Ribeiro-Alves, M.A.V.F ; Alves-Filho, G ; Mazzali, M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c529t-24d2cb15fda5574968c2c3607d72949e57f5cc8e11cd4fa90794292bdd0c6de43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Complement System Proteins - metabolism</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Graft Survival - physiology</topic><topic>Humans</topic><topic>Kidney Failure, Chronic - surgery</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Kidney Transplantation - physiology</topic><topic>Lupus Erythematosus, Systemic - epidemiology</topic><topic>Medical sciences</topic><topic>Postoperative Complications - epidemiology</topic><topic>Recurrence</topic><topic>Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>Time Factors</topic><topic>Tissue, organ and graft immunology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Signori Baracat, A.L</creatorcontrib><creatorcontrib>Ribeiro-Alves, M.A.V.F</creatorcontrib><creatorcontrib>Alves-Filho, G</creatorcontrib><creatorcontrib>Mazzali, M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Signori Baracat, A.L</au><au>Ribeiro-Alves, M.A.V.F</au><au>Alves-Filho, G</au><au>Mazzali, M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Systemic Lupus Erythematosus After Renal Transplantation: Is Complement a Good Marker for Graft Survival?</atitle><jtitle>Transplantation proceedings</jtitle><addtitle>Transplant Proc</addtitle><date>2008-04-01</date><risdate>2008</risdate><volume>40</volume><issue>3</issue><spage>746</spage><epage>748</epage><pages>746-748</pages><issn>0041-1345</issn><eissn>1873-2623</eissn><coden>TRPPA8</coden><abstract>Abstract Background Renal transplantation is considered a safe procedure for patients with systemic lupus erythematosus (SLE). However, the recurrence of disease and its impact on graft survival remains controversial. Methods To analyze the presence of lupus serology activity during dialysis and its impact on lupus recurrence after transplantation, we performed a retrospective analysis of 23 lupus patients who received 26 kidney transplantations. Results Twenty-three patients received 26 renal transplantations from 1984 to 2003. Twelve patients presented pretransplant lupus activity (low complement and ANA &gt; 1/40), without correlation with length of dialysis, but associated with proliferative glomerulonephritis (class IV) pretransplant. Among 26 grafts, 6 were lost in the first 6 months posttransplant. Among the remaining 20 functioning grafts, low complement activity occurred in 8, being associated with recurrence of immune deposits in 3 cases. Analysis of lupus activity showed that only one patient with a normal complement level posttransplant presented SLEDAI &gt; 4, associated with persistent proteinuria and a graft biopsy without immune deposits. Graft survival was reduced in the presence of low complement posttransplantation. Conclusion Low complement levels after renal transplantation, in association with proteinuria may be considered to be a risk factor for recurrence of immune deposits, with a negative impact on graft survival.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>18455005</pmid><doi>10.1016/j.transproceed.2008.02.045</doi><tpages>3</tpages></addata></record>
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subjects Biological and medical sciences
Biomarkers - blood
Complement System Proteins - metabolism
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Graft Survival - physiology
Humans
Kidney Failure, Chronic - surgery
Kidney Transplantation - adverse effects
Kidney Transplantation - physiology
Lupus Erythematosus, Systemic - epidemiology
Medical sciences
Postoperative Complications - epidemiology
Recurrence
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
Time Factors
Tissue, organ and graft immunology
title Systemic Lupus Erythematosus After Renal Transplantation: Is Complement a Good Marker for Graft Survival?
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