학술논문
Early steroid withdrawal in pediatric renal transplant: five years of follow-up.
Document Type
Article
Author
Source
Subject
*STEROID drugs
*ANALYSIS of variance
*CHI-squared test
*COMPARATIVE studies
*FISHER exact test
*GLOMERULAR filtration rate
*GRAFT rejection
*GRAFT versus host reaction
*IMMUNOSUPPRESSIVE agents
*KIDNEY transplantation
*LONGITUDINAL method
*MONOCLONAL antibodies
*HEALTH outcome assessment
*RESEARCH funding
*STEROIDS
*SURVIVAL analysis (Biometry)
*T-test (Statistics)
*TREATMENT effectiveness
*REPEATED measures design
*DATA analysis software
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Language
ISSN
0931-041X
Abstract
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/m 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 m) 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. [ABSTRACT FROM AUTHOR]