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Objectives Lupus nephritis (LN) is a serious complication of systemic lupus erythematosus (SLE) affecting to 40-60% of SLE. End-stage renal disease (ESRD) occurs in up to 10-20% of LN, occasionally requiring kidney transplantation (KT).In a series of LN patients who underwent KT, our aim was to assess a) clinical and histological features, b) frequency of renal graft loss, and c) SLE and LN flares.Methods Multicenter study of all consecutive patients who underwent KT due to LN in 10 Spanish reference University hospitals between January 1980 and December 2023. Demographic, epidemiological, clinical, analytical and histological data on SLE and LN were collected. In addition, cases of graft loss and their causes, as well as LN flares, were recorded.Results We include 103 (80 women, 77.7%), patients; mean age of 38.6±17.1 years. When KT was performed, the main clinical manifestations were joint (n=54; 52.4%) and mucocutaneous involvement (n=44, 42.7%). The predominant histological diagnosis of LN was class IV (n= 47, 45.6%), followed by class III (n=12; 11.6%). The main general features are summarized in table 1.The subtypes of renal replacement therapy (RRT) used prior to KT were: hemodialysis (n=67, 65%), peritoneal dialysis (n=17, 16.5%), combined therapy (n=9, 8.7%) The median [IQR] time from initiation of RRT to KT was 3 years [1-5].The most frequently reported types of donations were brain death (n=45, 43.7%) and asystole (n=29, 28.2%).Renal graft loss was observed in 31 (30.1%) patients. The most common causes were: acute rejection (n=11, 35.5%), chronic rejection (n=8, 25.8%), combined acute and chronic rejection (n=5, 16.2%), graft thrombosis (n=4, 12.9%) (table 2).In most patients, the graft remains functional (n= 65; 63%). A SLE flare was observed in 17 (13.1%) patients, with renal involvement in 6 (5.8%) cases. LN flare in the graft was the cause of organ loss in only 3 patients (9.7%).Abstract PO:04:116 Table 1–2Conclusions Despite concerns about the recurrence of LN after KT, our results indicate that graft loss is lower in our cohort compared to other published series, and that LN recurrence in the graft is not a frequent cause of organ loss.