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Lupus Kidney Transplant

Discover the hope of lupus kidney transplants. Explore how lupus can affect the kidneys and why a transplant can be life-changing. Join us on this journey of possibility and learn about the transformative impact of kidney transplants for those with lupus.

  • Kidney Transplant

By Ipshita Ghoshal

3rd July '23

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Overview

A lupus kidney transplant is a surgery to replace their damaged kidneys. Lupus can damage the kidneys and make them stop working properly. In this procedure, a healthy kidney from a donor is put into the person with lupus. This new kidney helps their kidneys work better and improves their health and how they feel. The transplant needs careful planning and preparation to get the best outcome. 

It is crucial to take medicines and make lifestyle changes. This is  to prevent the body from rejecting the new kidney. These measures also aid in a smooth recovery and promote overall well-being.

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How does lupus affect the kidneys?

Lupus nephritis is a common issue in people with lupus. It is a disease where the immune system attacks the body tissues, including the kidneys. It causes inflammation in the kidneys and can lead to problems with kidney function.

Lupus nephritis happens when the kidneys get inflamed because of this attack. It can cause symptoms like 

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  • Blood or protein in the urine
  • High blood pressure
  • Problems with kidney function
  • Kidney failure/ bleeding.

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But here's the fascinating part: a lupus kidney transplant offers hope for a brighter future

Can someone with lupus get a kidney transplant?

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Yes, people with lupus can undergo a kidney transplant if their kidneys are totally damaged. A kidney transplant is an option for those who have reached the stage of kidney failure. Also to get the transplantation done, they need to meet certain criteria.
 A lupus kidney transplant can improve the quality of life and kidney function. and kidney failure. However, it's a big decision that requires careful consideration and ongoing medical care. It's important to consult with healthcare professionals to determine the best approach for each individual.

Find out if you meet the criteria for a life-altering lupus kidney transplant.

What are the criteria for a kidney transplant for someone with lupus?

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Criteria for kidney transplant eligibility in individuals with lupus depend on various factors. When lupus nephritis progresses to end-stage renal failure, a kidney transplant may be considered as a treatment option. Several criteria and considerations determine eligibility:

1. Medical Evaluation: A balance must be struck between the need for a transplant and the candidate's overall health. He/she should have the ability to undergo surgery and recovery. Rheumatologists or nephrologists assess the need for a transplant.  

2. Exclusionary Factors: Certain conditions, like smoking, substance abuse, HIV, and hepatitis, may disqualify individuals from receiving a kidney transplant.

3. Medical Tests: Comprehensive medical tests evaluate kidney, lung, and heart function. Psychological assessments determine mental well-being and the presence of a support network.

4. Commitment to Lifestyle Changes: Candidates must commit to a lifestyle that promotes the health of the transplanted kidney. These include 

  • daily immunosuppressant medication
  • healthy diet
  • exercise 
  • stress management

5. Transplant Center Criteria: Eligibility criteria may vary among transplant centers. Rejection at one center does not necessarily mean rejection at another. After qualifying, candidates join the national waiting list. The list often has more individuals awaiting organs than available donations.

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What are the risks of a kidney transplant for someone with lupus?

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Risks of kidney transplant for someone with lupus:

  • Rejection: The immune system may reject the transplanted kidney.
  • Infection: Weakened immune system from medications increases the risk of infections.
  • Medication-related complications: Long-term use of immunosuppressants can have side effects.
  • Recurrence of lupus nephritis: Lupus-related kidney inflammation may affect the new organ.
  • Surgical complications: Risks associated with surgery, such as bleeding and infection.
  • Long-term complications: Possibility of chronic rejection and other kidney-related issues.
  • Medication adherence: Consistent use of immunosuppressant medications is crucial.

Please note that these risks should be discussed further with healthcare professionals. You should fully understand their implications for individual cases.


How long after being diagnosed with lupus can someone get a kidney transplant?

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Usually, it's recommended to control lupus-related kidney issues before thinking about a transplant. This often involves taking medicines to manage lupus symptoms. This reduces kidney inflammation. The length of this treatment can vary depending on the person. And also how they respond to the medicines.


Once the kidney problems are stable or better, the person can be evaluated for a transplant. This evaluation includes different tests to check overall health. kidney function is evaluated and  If the person is a good match for a donor kidney. Doctors also consider how prepared the person is both physically and emotionally for the transplant.


The timing for a lupus kidney transplant after a lupus diagnosis depends on the individual situation. It's important to work closely with healthcare professionals who can give personalized advice. This is based on the person's medical history, current condition, and how they respond to treatment.

Discover how these risks can be managed and overcome in a lupus kidney transplant. 

What medications are used to prevent rejection of a kidney transplant in lupus patients?

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Immunosuppressive medications are drugs that help suppress the immune system. They are commonly used in organ transplant patients to prevent organ rejection. However, they are also used in the treatment of certain autoimmune diseases.  Like lupus and rheumatoid arthritis.

Some commonly used immunosuppressive medications for lupus include:

  •  Azathioprine (Imuran): It is an anti-inflammatory immunosuppressive. It can decrease joint damage and disability in lupus. It is often used as a "steroid-sparing" medication. It reduces the need for high doses of steroids.
  • Mycophenolate mofetil (Cellcept): This medication is commonly used in lupus patients with kidney involvement (lupus nephritis). It impairs immune system function by targeting the enzyme involved in DNA formation. Like azathioprine, it is also steroid-sparing.
  • Cyclosporine (Neoral, Sandimmune, Gengraf): Cyclosporine is a potent immunosuppressive. It blocks the function of T-lymphocytes. l. It is primarily used for severe lupus nephritis that does not respond to other medications. It can also help reduce joint pain, swelling, and stiffness linked to lupus arthritis.
  • Methotrexate (Rheumatrex): Methotrexate is another immunosuppressive drug used in the treatment of lupus. It works by interfering with the synthesis of DNA. It inhibits cell division. It is often prescribed for joint and skin symptoms in lupus.
  • Leflunomide (Arava): It is also an immunosuppressive medication that inhibits the synthesis of DNA and RNA. It is primarily used in the treatment of rheumatoid arthritis but may also be prescribed for lupus.
  • Cyclophosphamide (Cytoxan): Cyclophosphamide is a potent immunosuppressive. It is also a chemotherapy drug. It is used in severe cases of lupus nephritis.  It works by suppressing the immune system and inhibiting the growth of rapidly dividing cells.
  • Chlorambucil (Leukeran) and nitrogen mustard (Mustargen): These medications are alkylating agents that suppress the immune system. They inhibit cell division. They are used in certain cases of severe lupus that do not respond to other treatments.

Discover the effectiveness of a lupus kidney transplant in the section below! 

What are the success rates for a kidney transplant in lupus patients? 

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In a study, researchers looked at how well kidney transplants worked for people with lupus. They found that the ten-year survival rate was 90% for those who got a kidney transplant. 81% for those on peritoneal dialysis, and 55% for those on hemodialysis. The people who received a kidney transplant were generally younger.


No patient showed lupus flare up during the study.  while 50% of those on peritoneal dialysis and 14% of those on hemodialysis had flare-ups.


So, the study suggests that kidney transplants can be a good option for people with lupus. They have higher survival rates and lower chances of lupus flare-ups compared to dialysis treatments. But it's important to talk to a doctor to see what's best for each person.


 

Are there any lifestyle changes someone with lupus should make before getting a kidney transplant?

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To prevent lupus nephritis, individuals with lupus should make these lifestyle changes:

  • Follow a low-salt diet.
  • Avoid smoking and alcohol.
  • Engage in regular exercise.
  • Use caution with pain medications and alternative remedies.

These lifestyle modifications will help the individuals with lupus to reduce the risk of lupus nephritis. 


How long is the recovery time for a kidney transplant in someone with lupus?

The recovery time after a lupus kidney transplant can be different for each person. It takes about 4 to 6 weeks to recover from the surgery itself. During this time, doctors closely watch patients to make sure the new kidney is working well and not being rejected by the body.

After the initial recovery period, the person will need to take medicines to prevent rejection of transplanted kidney. These medicines may have side effects and require regular check-ups with the doctor.

It may take several months for someone with lupus kidney transplant to fully get back to their normal activities. The time it takes to recover depends on factors like overall health, any complications that happen, and how well the new kidney is working.

To have a successful recovery, it's important for the person to follow the doctor's instructions. Talking to the healthcare team regularly can help understand the specific recovery timeline and address any concerns.

According to Study Medicine in Europe stated that-

After a kidney transplant, the management of lupus typically changes. Since the new kidney usually takes over the filtration function, lupus-related kidney disease is effectively treated. However, lupus is a systemic autoimmune disease, and other manifestations of lupus can still be present after the transplant. Therefore, ongoing management of lupus involves monitoring and controlling non-renal manifestations through medications and regular follow-up with rheumatologists.

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Can lupus come back after a kidney transplant?

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According to a study, the recurrence of lupus nephritis can happen within the first week. There are many cases where it may appear later, up to 16 months after the transplant. The majority of these events typically occur within the initial 10 years following the transplantation. After a kidney transplant, there is a small chance that lupus can come back, but it doesn't happen very often. This is called recurrent lupus nephritis. It affects around 5% to 30% of patients.

FAQs

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Q1. What is the success rate of kidney transplantation in people with lupus nephritis?

ANS: 1-year survival rates for the transplanted kidney are 90% to 95%, and 5-year survival rates are 75% to 85%.
 

Q2. Can lupus nephritis recur after a successful kidney transplant? 

Ans: Yes, there is a risk of lupus nephritis recurrence after a successful kidney transplant.
 

Q3. How can people with lupus prepare for a kidney transplant surgery? 

Ans: People with lupus should undergo a comprehensive medical evaluation, discuss their medications with their healthcare team, and optimize their overall health before the surgery.


 Q4. Can pregnancy be a concern after a kidney transplant in women with lupus? 

Ans: Yes, pregnancy can be a concern after a kidney transplant in women with lupus, and they should discuss their options with their healthcare team.

Q5. How can a person with lupus prevent infection after a kidney transplant? 

Ans: People with lupus can prevent infection after a kidney transplant by practicing good hygiene, avoiding crowds and sick people, and taking immunosuppressant medications as prescribed.

Q6. Can living kidney donation be an option for people with lupus who need a kidney transplant? 

Ans: Yes, living kidney donation can be an option for people with lupus who need a kidney transplant, but careful evaluation is necessary to ensure the safety of the donor and the recipient.
 

Q7. Is there any link between lupus and certain types of kidney transplant complications? 

Ans: Yes, lupus is associated with an increased risk of certain types of kidney transplant complications such as rejection and infections.

Q8. How long does the recovery period typically last for a person with lupus who undergoes a kidney transplant? 

Ans: The recovery period can vary depending on individual factors, but generally takes several weeks to several months.

Reference-

https://www.lupus.org/resources/kidney-transplant-for-lupus-your-essential-questions-answered#:~:text=Many%20people%20find%20that%20after,help%20keep%20lupus%20symptoms%20away.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4208080/

https://www.kidney.org/atoz/content/lupus



 

Frequently Asked Questions

What are the eligible criteria for a kidney transplant in India?

Can a foreigner undergo a kidney transplant in India?

Are there any age restrictions for kidney transplant recipients in India?

What are the risks associated with kidney transplantation in India?

How long do transplanted kidneys typically last in India?

Is it possible to receive a kidney from a living donor in India?

What is the waiting period for a kidney transplant in India?

What should I expect during the evaluation process for kidney transplantation in India?

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Question and Answers

Please help me, my father is scheduled to have a kidney transplant next week. Is there any chance of failure in this procedure? And if yes, then what happens next?

Transplant it is a super major surgery. Any kind of transplant has its complications, and graft rejection is one of them. There are many other complications associated with the kidney transplant therefore transplant needs a multidisciplinary approach and a team of experts to deal with such patients.

 

Consultant kidney transplant doctors as they will be in a better position to guide you accordingly, because everything depends on patients age, his condition associated comorbidities, the match of the graft and many other factors. Consult a transplant specialist for guidance. Hope our answer helps you.

Answered on 10th June '23

Dr. Babita Goel

Dr. Babita Goel

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