Early steroid withdrawal in pediatric renal transplant: five years of follow-up
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Ángela Delucchi & Marcela Valenzuela & Ana M. Lillo & Jose Luis Guerrero & Francisco Cano & Marta Azocar & Pedro Zambrano & Paulina Salas & Viola Pin
- چاپ و سال / کشور: 2011
Description
This prospective, comparative trial investigated the impact on mean change in height standard deviation score (SDS), acute rejection rate, and renal function of early steroid withdrawal in 96 recipients with 5 years of follow-up. Recipients under basiliximab induction and steroid withdrawal (SW: TAC/MMF; n=55) were compared with a matched steroid control group (SC: TAC/MMF/STEROID, n=41). SW received steroids until Day 6, SC decreased to 10 mg/m2 within 2 months post-transplant. Five years after SW, the longitudinal growth (SDS) gain was 1.4±0.4 vs. 1.1±0.3 for SC group (p<0.02). Height benefits in prepubertal and pubertal status in both groups were demonstrated in the delta growth trends (mixed model; p<0.01). Biopsy-proven acute rejection in SW was 11% and 17.5%, SC (p: ns). Mean eGFR (ml/min/1.73 m2) at 5 years post-transplant was SW 80.6± 27.8 vs. 82.6±25.1 for SC (p: ns). The death-censored graft survival rate at 1 and 5 years was 99 and 90% for SW; 98 and 96% for SC (p = ns). PTLD incidence in SW 3.3 vs. 2.5% in SC (p: ns). Five years post-transplant, early steroid withdrawal showed positive impacts on growth, stable renal function without increased acute rejection risk, and PTLD incidence.
Pediatr Nephrol DOI 10.1007/s00467-011-1934-6 Received: 16 October 2010 / Revised: 17 May 2011 / Accepted: 26 May 2011
