Kidney Week

Abstract: TH-PO1008

Long-Term Outcomes in Kidney Transplant Recipients with Systemic Lupus Erythematosus vs. ADPKD

Session Information

• Transplantation: Clinical - Outcomes, Malignancy, and Pathology
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2002 Transplantation: Clinical

Authors

• Gaitán Cruz, Carolina, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico

Carolina Gaitán Cruz, MD

• Reyes-Moreno, Juan-Esteban, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico

Juan-Esteban Reyes-Moreno

• Santos, Julio Cesar, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico

Julio Cesar Santos, MD

• Matías Martinez, Melvin Barish, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico

Melvin Barish Matías Martinez, MD

• Morales-Buenrostro, Luis E., Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico

Luis E. Morales-Buenrostro, MD, PhD

• Berman, Nathan, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico

Nathan Berman, MD

• Mejia-Vilet, Juan M., Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico

Juan M. Mejia-Vilet, MD, PhD

Background

Long-term kidney transplant outcomes in systemic lupus erythematosus (SLE) remain incompletely characterized. Patients with autosomal dominant polycystic kidney disease (ADPKD) represent an optimal non-autoimmune chronic kidney disease comparator group. We assessed renal and patient outcomes after kidney transplantation in SLE versus ADPKD patients.

Methods

We conducted a retrospective cohort study including consecutive patients with SLE or ADPKD who underwent kidney transplantation between 2001 and 2025. Demographics, comorbidities, transplant-related variables, histopathology, and treatment data were collected. Outcomes were assessed using time-to-event analyses and included allograft survival, patient survival, antibody-mediated rejection (AMR), cellular rejection, thrombotic events, and recurrent disease.

Results

We included 125 patients with SLE and 61 with ADPKD. Patients with SLE were younger (median 32 years vs. 51 years, p<0.001), more frequently female (82% vs 39%, p<0.001), had lower rates of diabetes, and more commonly shared two HLA haplotypes with donors (12% vs 3%). There were no differences in donor type (living vs deceased donor), induction therapy, or maintenance immunosuppression. Ten-year allograft survival (88% vs 91%, p=0.254) and patient survival (94% vs. 88%, p=0.497) were comparable between groups. However, SLE patients had a shorter time to first cellular (HR 2.29, 95%CI 1.06-4.96) or antibody-mediated (HR 2.04, 95%CI 1.04-4.03) rejection. Rates of thrombotic events and post-transplant diabetic nephropathy were similar between groups. Histologic lupus nephritis recurrence occurred in 12% and 21% of patients at 5 and 10 years, respectively.

Conclusion

Long-term allograft and patient survival after kidney transplantation in SLE are comparable to those observed in ADPKD. Although histologic recurrence of lupus nephritis was relatively common, it was not associated with an apparent adverse clinical impact. SLE patients may experience higher rejection burden compared with ADPKD recipients.

Acknowledgment

None.

Kaplan-Meier plot of allograft survival (A) and antibody-mediated rejection (B) in the study groups