Graft and Recipient Survival Analysis of Renal Transplantation in Rheumatic Diseases: A Retrospective Case-Control...

In this study, we aimed to evaluate the long-term outcomes of renal transplant in patients with rheumatic diseases.

In this retrospective case-control study, we analyzed and compared outcomes of 187 patients who underwent renal transplant because of rheumatic disease-associated renal failure between the years 1994 and 2020 versus a control transplant group (n = 325), matched for age, sex, body mass index, and follow-up duration.

Among patients in the rheumatic disease group, AA amyloidosis was the most common renal pathology leading to kidney transplant. Delayed graft function, acute rejection, and mortality were more common in the rheumatic disease group. Survival rates in recipients at 1, 5, 10, and 15 years were lower in the rheumatic disease group than in the control group (log-rank 0.046), whereas graft survival rates were found to be similar (log-rank 0.206). Recipient survival rates at 1, 5, 10, and 15 years in patients in the rheumatic disease group with AA amyloidosis were significantly worse compared with patients in the rheumatic disease group with glomerulonephritis (log-rank 0.006). Advanced recipient age and graft loss were found to be independent risk factors for mortality in the Cox regression analysis.

Delayed graft function, acute rejection, and mortality rates were higher in patients who had kidney transplants because of rheumatic diseases. Patients with secondary amyloidosis associated with rheumatic disease had worse long-term renal transplant outcomes.