| Title | Kidney transplantation with corticosteroid-free maintenance immunosuppression: a single center analysis of graft and patient survivals. | | Author(s) | Filipe R, Mota A, Alves R, Bastos C, Macário F, Figueiredo A, Roseiro A, Parada B, Sá H, Nunes P, Bastos M | | Institution | Renal Transplantation Unit, Departments of Urology and Kidney Transplantation, Coimbra University Hospital, Coimbra, Portugal. rmafilipe@gmail.com | | Source | Transplant Proc 2009 Apr; 41(3):843-5. | | MeSH | Adrenal Cortex Hormones
Adult
Cause of Death
Drug Therapy, Combination
Female
Graft Survival
Humans
Immunosuppression
Immunosuppressive Agents
Kidney Transplantation
Male
Middle Aged
Patient Selection
Reoperation
Retrospective Studies
Survival Rate
Survivors
Young Adult
| | Abstract | The purpose of this study was to assess the impact of a corticosteroid-free maintenance immunosuppression on graft survival in kidney transplantation. We analyzed 79 patients who were transplanted between June 1, 2006 and May 31, 2007. We excluded hyperimmunized patients, second transplantations, living donors, and black recipients. Patients underwent induction with thymoglobulin or basiliximab, followed by treatment with mycophenolate mofetil (MMF), tacrolimus, and methylprednisolone. On the 5th day, the patients were divided into 2 groups: group A (n = 45) discontinued steroid therapy; group B (n = 34) continued prednisone therapy. We performed a comparative analysis of incidence of delayed graft function (DGF), acute rejection episodes (ARE), renal function at 6 and 12 months, graft and patient survivals, causes of graft loss, and mortality. The 2 groups were similar for donor, recipient, and graft characteristics. The incidences of DGF were 8.9% in group A and 14.7% in group B; those for ARE were 2.3% in group A and 13.8% in group B (P = .077). The mean serum creatinine levels at 6 and 12 months were similar. There were 8 graft losses: 3 in group A (3 deaths with functioning grafts) and 5 in group B (1 death, 3 vascular causes, 1 kidney nonfunction). The 4 deaths were due to infection (n = 3) or neoplasia (n = 1). Graft survivals at 1 year were 98% in group A and 85% in group B, and patient survivals were 98% and 97%, respectively. An immunosuppressive regimen using antibody induction and steroid-free treatment proved to be effective in low-risk patients. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 19376367 |
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