Kidney Transplantation in Patients with Systemic Lupus Erythematosus: A Nationwide Population-based Epidemiology and Outcome Analysis in Taiwan

Yu-Sheng Chang, Tsai-Hung Wu, Tzeng-Ji Chen, Chien Chih Lai, Hui-Ting Lee, Wei-Sheng Chen, Chung-Tei Chou, Chang-Youh Tsai

Research output: Contribution to journalArticle

Abstract

Objective: To determine the epidemiology and outcome of patients with systemic lupus erythematosus (SLE) that underwent kidney transplantation in Taiwan.Methods: We retrieved data from the National Health Insurance Research Dataset (NHIRD) and included those patients with newly developed end-stage renal disease (ESRD) who were recognized as having underlying SLE between April 1997 and December 2006. Among these patients we analyzed clinical as well as graft outcome in renal transplant recipients and clinical outcome in those not undergoing renal transplantation.Results: 1073 SLE-ESRD patients, including 115 renal transplant recipients, were analyzed. The mean age on receiving renal allograft was 35.5 years, with a female to male ratio of 4.23:1. The 1-year and 4-year survival rates of the allografts (AS) and the recipients (RS) were 0.94/0.88 (AS) and 0.96/0.93 (RS), respectively. Clinical survival of transplant patients was superior to that of non-transplant patients (hazard ratio = 0.35; 95% CI = 0.14-0.85; p=0.021) after adjusting other major prognosis factors. Factors such as gender, age at transplantation, waiting time for the graft, economic status, pre-transplant renal replacement therapy (RRT) and co-morbidities with hepatitis B (HBV), hepatitis C (HCV), diabetes mellitus (DM) and/or sicca complex had no significant effect on graft success or failure.Conclusion: The clinical and graft survival rates were good in lupus renal transplant recipients in Taiwan. Further in-depth comparison of these features with those of Caucasians or other Asian countries is mandatory to reach a definite conclusion.
Original languageEnglish
Pages (from-to)61-68
Number of pages8
JournalFormosan Journal of Rheumatology
Volume25
Issue number1&2
DOIs
Publication statusPublished - Dec 3 2011
Externally publishedYes

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Taiwan
Systemic Lupus Erythematosus
Kidney Transplantation
Epidemiology
Transplants
Population
Allografts
Kidney
Chronic Kidney Failure
Survival Rate
Renal Replacement Therapy
National Health Programs
Graft Survival
Hepatitis C
Hepatitis B
Diabetes Mellitus
Transplantation
Economics
Morbidity
Research

Keywords

  • Systemic lupus erythematosus (SLE)
  • kidney transplantation
  • end-stage renal disease (ESRD)
  • clinical survival
  • graft survival

Cite this

Kidney Transplantation in Patients with Systemic Lupus Erythematosus: A Nationwide Population-based Epidemiology and Outcome Analysis in Taiwan. / Chang, Yu-Sheng; Wu, Tsai-Hung; Chen, Tzeng-Ji; Lai, Chien Chih; Lee, Hui-Ting; Chen, Wei-Sheng; Chou, Chung-Tei; Tsai, Chang-Youh.

In: Formosan Journal of Rheumatology, Vol. 25, No. 1&2, 03.12.2011, p. 61-68.

Research output: Contribution to journalArticle

Chang, Yu-Sheng ; Wu, Tsai-Hung ; Chen, Tzeng-Ji ; Lai, Chien Chih ; Lee, Hui-Ting ; Chen, Wei-Sheng ; Chou, Chung-Tei ; Tsai, Chang-Youh. / Kidney Transplantation in Patients with Systemic Lupus Erythematosus: A Nationwide Population-based Epidemiology and Outcome Analysis in Taiwan. In: Formosan Journal of Rheumatology. 2011 ; Vol. 25, No. 1&2. pp. 61-68.
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abstract = "Objective: To determine the epidemiology and outcome of patients with systemic lupus erythematosus (SLE) that underwent kidney transplantation in Taiwan.Methods: We retrieved data from the National Health Insurance Research Dataset (NHIRD) and included those patients with newly developed end-stage renal disease (ESRD) who were recognized as having underlying SLE between April 1997 and December 2006. Among these patients we analyzed clinical as well as graft outcome in renal transplant recipients and clinical outcome in those not undergoing renal transplantation.Results: 1073 SLE-ESRD patients, including 115 renal transplant recipients, were analyzed. The mean age on receiving renal allograft was 35.5 years, with a female to male ratio of 4.23:1. The 1-year and 4-year survival rates of the allografts (AS) and the recipients (RS) were 0.94/0.88 (AS) and 0.96/0.93 (RS), respectively. Clinical survival of transplant patients was superior to that of non-transplant patients (hazard ratio = 0.35; 95{\%} CI = 0.14-0.85; p=0.021) after adjusting other major prognosis factors. Factors such as gender, age at transplantation, waiting time for the graft, economic status, pre-transplant renal replacement therapy (RRT) and co-morbidities with hepatitis B (HBV), hepatitis C (HCV), diabetes mellitus (DM) and/or sicca complex had no significant effect on graft success or failure.Conclusion: The clinical and graft survival rates were good in lupus renal transplant recipients in Taiwan. Further in-depth comparison of these features with those of Caucasians or other Asian countries is mandatory to reach a definite conclusion.",
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T1 - Kidney Transplantation in Patients with Systemic Lupus Erythematosus: A Nationwide Population-based Epidemiology and Outcome Analysis in Taiwan

AU - Chang, Yu-Sheng

AU - Wu, Tsai-Hung

AU - Chen, Tzeng-Ji

AU - Lai, Chien Chih

AU - Lee, Hui-Ting

AU - Chen, Wei-Sheng

AU - Chou, Chung-Tei

AU - Tsai, Chang-Youh

PY - 2011/12/3

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N2 - Objective: To determine the epidemiology and outcome of patients with systemic lupus erythematosus (SLE) that underwent kidney transplantation in Taiwan.Methods: We retrieved data from the National Health Insurance Research Dataset (NHIRD) and included those patients with newly developed end-stage renal disease (ESRD) who were recognized as having underlying SLE between April 1997 and December 2006. Among these patients we analyzed clinical as well as graft outcome in renal transplant recipients and clinical outcome in those not undergoing renal transplantation.Results: 1073 SLE-ESRD patients, including 115 renal transplant recipients, were analyzed. The mean age on receiving renal allograft was 35.5 years, with a female to male ratio of 4.23:1. The 1-year and 4-year survival rates of the allografts (AS) and the recipients (RS) were 0.94/0.88 (AS) and 0.96/0.93 (RS), respectively. Clinical survival of transplant patients was superior to that of non-transplant patients (hazard ratio = 0.35; 95% CI = 0.14-0.85; p=0.021) after adjusting other major prognosis factors. Factors such as gender, age at transplantation, waiting time for the graft, economic status, pre-transplant renal replacement therapy (RRT) and co-morbidities with hepatitis B (HBV), hepatitis C (HCV), diabetes mellitus (DM) and/or sicca complex had no significant effect on graft success or failure.Conclusion: The clinical and graft survival rates were good in lupus renal transplant recipients in Taiwan. Further in-depth comparison of these features with those of Caucasians or other Asian countries is mandatory to reach a definite conclusion.

AB - Objective: To determine the epidemiology and outcome of patients with systemic lupus erythematosus (SLE) that underwent kidney transplantation in Taiwan.Methods: We retrieved data from the National Health Insurance Research Dataset (NHIRD) and included those patients with newly developed end-stage renal disease (ESRD) who were recognized as having underlying SLE between April 1997 and December 2006. Among these patients we analyzed clinical as well as graft outcome in renal transplant recipients and clinical outcome in those not undergoing renal transplantation.Results: 1073 SLE-ESRD patients, including 115 renal transplant recipients, were analyzed. The mean age on receiving renal allograft was 35.5 years, with a female to male ratio of 4.23:1. The 1-year and 4-year survival rates of the allografts (AS) and the recipients (RS) were 0.94/0.88 (AS) and 0.96/0.93 (RS), respectively. Clinical survival of transplant patients was superior to that of non-transplant patients (hazard ratio = 0.35; 95% CI = 0.14-0.85; p=0.021) after adjusting other major prognosis factors. Factors such as gender, age at transplantation, waiting time for the graft, economic status, pre-transplant renal replacement therapy (RRT) and co-morbidities with hepatitis B (HBV), hepatitis C (HCV), diabetes mellitus (DM) and/or sicca complex had no significant effect on graft success or failure.Conclusion: The clinical and graft survival rates were good in lupus renal transplant recipients in Taiwan. Further in-depth comparison of these features with those of Caucasians or other Asian countries is mandatory to reach a definite conclusion.

KW - Systemic lupus erythematosus (SLE)

KW - kidney transplantation

KW - end-stage renal disease (ESRD)

KW - clinical survival

KW - graft survival

KW - 全身性紅斑性狼瘡

KW - 腎臟移植

KW - 末期腎臟疾病

KW - 移植患者存活率

KW - 移植腎臟存活率

U2 - 10.6313/FJR.2011.25

DO - 10.6313/FJR.2011.25

M3 - Article

VL - 25

SP - 61

EP - 68

JO - Formosan Journal of Rheumatology

JF - Formosan Journal of Rheumatology

SN - 2075-0374

IS - 1&2

ER -