Potential influence of tacrolimus and steroid avoidance on early graft function in pediatric renal transplantation

Pediatric Transplantation
L LiMinnie M Sarwal

Abstract

With the increasing adoption of steroid-sparing immunosuppression protocols in renal transplantation, it is important to evaluate any adverse effects of steroid avoidance on graft function. Early graft function, measured by CrCl was retrospectively studied in 158 consecutive pediatric renal transplant recipients from 1996 to 2005, receiving either steroid-free or steroid-based immunosuppression. Patients receiving steroid-free immunosuppression vs. steroid-based immunosuppression had no difference change in CrCl (DeltaCrCl) in the first week post-transplantation (p = 0.12). When stratified by corticosteroid usage, patients with higher tacrolimus trough levels (> or =14 ng/mL) had slower graft function recovery in the first week post-transplantation than those with lower tacrolimus trough levels (p = 0.008) in the steroid-free group only. Despite initial slower graft function recovery in this subgroup, there was no negative impact on graft function in the steroid-free group; in fact steroid-free patients trended towards better CrCl at six months (p = 0.047) and 12 months (p < 0.001) post-transplant than the steroid-based group. With the improved immunological outcomes with steroid avoidance, close surveillance should be performe...Continue Reading

References

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Jan 3, 2006·Transplantation Proceedings·J PascualUNKNOWN Spanish Group for Evidence-Based Medicine in Renal Transplantation
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Aug 8, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·C A BögerB K Krämer

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Citations

Sep 22, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·E NehusE Abraham
Jun 16, 2011·British Journal of Clinical Pharmacology·Chaitali PasseyPamala A Jacobson
May 20, 2015·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Scott R AuerbachShelley D Miyamoto
Jul 6, 2014·Current Opinion in Organ Transplantation·Krisztina Rusai, Attila J Szabo
Jan 7, 2014·Transplantation·Scott R AuerbachBiagio A Pietra
Aug 15, 2012·Current Opinion in Organ Transplantation·Stephen D Marks
Dec 2, 2020·Transplantation Proceedings·Loes OomenCharlotte M H H T Bootsma-Robroeks
Nov 18, 2021·Pediatric Transplantation·Sarah J KizilbashBlanche Chavers

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