Early steroid withdrawal in pediatric renal transplant: five years of follow-up
| Autor: | Jorge Oswaldo Suárez Rodríguez, Viola Pinto, Angela Delucchi, Marta Azocar, Marcela Valenzuela, Paulina Salas, Ana Maria Lillo, Jose Luis Guerrero, Gabriel Cavada, Pedro Zambrano, Francisco Cano, Mario Ferrario |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Graft Rejection
Male Nephrology medicine.medical_specialty Adolescent Basiliximab Recombinant Fusion Proteins medicine.medical_treatment Urology Renal function Steroid withdrawal Steroid Adrenal Cortex Hormones Internal medicine medicine Humans Child business.industry Incidence (epidemiology) Longitudinal growth Antibodies Monoclonal Kidney Transplantation Body Height Endocrinology Renal transplant Child Preschool Pediatrics Perinatology and Child Health Female business Immunosuppressive Agents Follow-Up Studies medicine.drug |
| Zdroj: | PEDIATRIC NEPHROLOGY Artículos CONICYT CONICYT Chile instacron:CONICYT |
| ISSN: | 1432-198X 0931-041X |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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