Original InvestigationAntiphospholipid antibody syndrome in renal transplantation: Occurrence of clinical events in 96 consecutive patients with systemic lupus erythematosus
Section snippets
Materials and methods
We performed a retrospective review of 96 patients with SLE who underwent renal transplantation at the University of California, San Francisco (UCSF) from January 1, 1984, to September 1, 1996. We chose this starting date because nearly all patients who underwent transplantation at UCSF since that time received either cyclosporine or tacrolimus (FK506) as part of their immunosuppressive regimen. Thus, they represent a relatively uniform group with respect to immunosuppression. Potential
Results
Ninety-nine patients were identified through the computer search and cross-check previously described. Three patients were excluded from the study because review of their records failed to confirm the diagnosis of SLE. The 96 remaining patients met at least four of the revised criteria for the classification of SLE8 or had pretransplantation renal biopsies that confirmed the diagnosis of SLE nephritis. The 96 patients underwent 104 renal transplantation procedures.
We obtained follow-up data on
Discussion
In this series of 96 consecutive patients with SLE who underwent renal transplantation at our institution from 1984 to 1996, we identified 10 cases of posttransplantation morbidity and/or mortality attributable to the aPL syndrome. In 8.5% of the SLE patients (8 of 96 patients) who received renal transplants during this time period, the aPL syndrome contributed directly to the loss of the graft. In contrast to findings from a smaller study,15 these data suggest that aPLs have a significant
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2017, Kidney InternationalCitation Excerpt :In addition to local formed thrombosis, arterial embolisms from an upstream lesion have been reported in APS patients.23 In the setting of renal transplantation, a definite APS, or the presence of LA, seems to be associated with a high risk of large renal vessel thrombosis, leading to early graft loss.31–34 The pathophysiology of thrombosis in APS has been investigated extensively.
Received January 6, 1999; accepted in revised form June 25, 1999.
Address reprint requests to John H. Stone, MD, Division of Rheumatology, 1830 East Monument St, Suite 7500, Baltimore, MD 21205. E-mail: [email protected]