Early steroid withdrawal in repeat kidney transplantation

Muhammad A. Mujtaba, Tim E. Taber, William C. Goggins, Muhammad S. Yaqub, Dennis P. Mishler, Martin L. Milgrom, Jonathan A. Fridell, Andrew Lobashevsky, John A. Powelson, Asif A. Sharfuddin

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Background and objectives: Kidney re-transplantation (KRT) candidates are considered at high risk for graft failure. Most of these patients are kept on a chronic steroid maintenance (CSM) regimen. The safety of early steroid withdrawal (ESW) remains unanswered in KRT. Design, setting, participants, & measurements: This study was aimed at comparing the outcomes of ESW and CSM in KRT. Retrospective analysis of 113 KRT patients (ESW, n = 59; CSM, n = 54) was performed. All patients received rabbit anti-thymocyte globulin/steroid induction and were maintained on mycophenolate/tacrolimus (±steroids). Results: One- and 5-year patient survival for the ESW and the CSM group were not significantly different (98 versus 96% and 91 versus 88%, respectively; P = 0.991). No significant difference was seen in the graft survival for both groups at 1 and 5 years (98 versus 93% and 80 versus 74%, respectively; P = 0.779). Mean 1- and 5-year estimated GFR was not statistically different between the groups (P = 0.773 and 0.790, respectively). The incidence of acute rejection at 1 year was 17 and 22% in ESW and CSM patients, respectively (P = 0.635). Compared with the ESW group, patients in the CSM group were more likely to be hyperlipidemic (P = 0.044), osteoporotic (P = 0.010), post-transplant diabetics (P = 0.051) and required more medications to control BP (P = 0.004). Conclusions: ESW seems to be a reasonable approach in KRT recipients because the short and intermediate patient survival, graft survival, and graft function is comparable to CSM immunosuppression.

Original languageEnglish (US)
Pages (from-to)404-411
Number of pages8
JournalClinical Journal of the American Society of Nephrology
Volume6
Issue number2
DOIs
StatePublished - Feb 1 2011
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

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    Mujtaba, M. A., Taber, T. E., Goggins, W. C., Yaqub, M. S., Mishler, D. P., Milgrom, M. L., Fridell, J. A., Lobashevsky, A., Powelson, J. A., & Sharfuddin, A. A. (2011). Early steroid withdrawal in repeat kidney transplantation. Clinical Journal of the American Society of Nephrology, 6(2), 404-411. https://doi.org/10.2215/CJN.05110610