The current issue of ASN Kidney News reviews a presentation that was at ASN this year. ASN San Diego 2009, a presentation showed that recurrent lupus nephritis is uncommon in lupus patients who receive a kidney transplant, but the condition often leads to rejection and loss of transplant with an increased risk of death after transplantation.
The study group analyzed 6850 patients with a history of lupus who received kidney transplants between 1987 and 2006. The researchers found that lupus nephritis occurred in 2.44 percent of individuals in the study and that it led to a fourfold increased risk of kidney transplant
failure. Also, death occurred in approximately 16 percent of affected transplant recipients. African Americans, younger women, were certain risk factors.
This comes as a no surprise to me. Another presentation I went to in the ATC 2009 from Europe had mentioned that when they did protocol biopsies in lupus transplanted patients, they did find low grade Lupus Class II in many of these patients. Likely what is happening is they are heavily immunosuppresed, so what drugs we are using for rejection is also helping the lupus to be under control. Perhaps, the Steroids, Cellcept , CNI combination might be a good treatment for lupus then? rather than just cellcept or cytoxan with steroids. Perhaps lupus requires three tier treatment like transplant patients do.
Things we can learn from transplant patients!
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