Journal
AMERICAN JOURNAL OF TRANSPLANTATION
Volume 4, Issue 6, Pages 980-987Publisher
WILEY
DOI: 10.1111/j.1600-6143.2004.00443.x
Keywords
kidney transplant; steroid-free
Categories
Funding
- NIDDK NIH HHS [DK 13083] Funding Source: Medline
Ask authors/readers for more resources
Historically, late steroid withdrawal after kidney transplants has been associated with an increased rejection rate. Recently, low rejection rates have been reported for recipients treated with complete avoidance or rapid elimination of steroids. However, follow-up has been short. We herein report on 3- year outcome in recipients whose prednisone was rapidly eliminated and who were maintained on a steroid-free regimen. From 10/1/1999 through 5/1/2003, 349 recipients (254 LD, 95 CAD; 319 in first 30 s) were immunosuppressed with polyclonal antibody (Thymoglobulin), a calcineurin inhibitor, either mycophenolate mofetil or sirolimus, and rapid discontinuation of prednisone. Actuarial 3- year patient survival was 95%; graft survival, 93%. Acute rejection-free graft survival at 1 year was 94%; at 3 years, 92%. There was no difference between LD and CAD. At 2 years, the mean (+/-SE) serum creatinine level for LDs was 1.6+/-0.5 mg/dL; for CAD, 1.6+/-0.4 mg/dL. We have no new cases of PTLD or avascular necrosis; 22 recipients (6%) developed CMV. Currently, 84% of recipients remain prednisone-free. We conclude that excellent 3- year patient and graft survival can be achieved without maintenance prednisone. With such a protocol, steroid-related side-effects are minimal.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available