Long-Term Study of Steroid Avoidance in Renal Transplant Patients: A Single-Center Experience
| Autor: | Mohammed M Abuelmagd, Mohamed Hamed Abbas, M.A. Bakr, Ayman F. Refaie, Ahmed Abdelfattah Denewar, Ahmed H Neamatalla, Ayman Maher Nagib |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Time Factors Adolescent Basiliximab medicine.medical_treatment Single Center Mycophenolic acid law.invention Young Adult Randomized controlled trial law Internal medicine medicine Humans Prospective Studies Child Transplantation business.industry Contraindications Incidence Graft Survival Immunosuppression Middle Aged Kidney Transplantation Tacrolimus Surgery Survival Rate Regimen Child Preschool Female Steroids business Immunosuppressive Agents Switzerland Follow-Up Studies medicine.drug |
| Zdroj: | Transplantation Proceedings. 47:1099-1104 |
| ISSN: | 0041-1345 |
| Popis: | Objectives. Steroids have played a major role in renal transplantation for more than 4 decades. However, chronic use of steroids is associated with many comorbidities. This study aimed to assess the costs and benefits of a steroid-free immunosuppression regimen in a prospective randomized controlled study of living-donor renal transplantation, which was lacking in the literature. Materials and Methods. In our study, 428 patients were enrolled to receive tacrolimus (Tac), mycophenolic acid (MPA), basiliximab (Simulect, Novartis, Basel, Switzerland) induction and steroids only for 3 days (214 patients, study group) and steroid maintenance (214 patients, control group). Median follow-up was 66 � 41 months. Results. We found that both groups showed comparable graft and patient survival, rejection episodes, and graft function. Posttransplantation hypertension was detected in 40% of the steroid-free group and 80% of the steroid maintenance group (P ¼ .05), whereas posttransplantation diabetes mellitus was detected in 5% and 15% of these 2 groups, respectively (P ¼ .3). Conclusions. Among low-immunological-risk recipients of living-donor renal transplants, steroid avoidance was feasible, safe, and had less morbidity outcome using Simulect induction, then Tac and MPA as maintenance immunosuppression. Steroid avoidance was associated with a lower total cost despite comparable immunosuppression cost, which was attributed to the lower cost of associated morbidities. |
| Databáze: | OpenAIRE |
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