The 1975 observations of the Advisory Committee of the Renal Transplant Registry about systemic lupus erythematosus (SLE) remain largely unaltered. The SLE patient's survival after renal transplantation has improved, but remains similar to the non-SLE transplantation population. Disease activity declines throughout the transplantation period with a low rate of graft loss due to recurrent disease. There is slight discordant evidence about spontaneous renal recovery and graft survival rates in the SLE transplant population. The latter difference may relate to variances in the donor source (live-related versus cadaveric). The original report did not address the now well-recognized immediate- and long-term risks posed by the anti-phospholipid antibody syndrome, the accelerated rate of vascular disease, hematologic malignancies, and corticosteroid osteoporosis in the SLE transplant recipient.