Long‐term outcome of early steroid withdrawal in pediatric renal transplantation

Abstract

Background: Steroid use in renal transplant is related to multiple adverse effects.Long-term effects of early withdrawal steroids in pediatric renal transplant were assessed.Methods: Renal transplant children with low immunological risk treated on basiliximab, tacrolimus, and mycophenolate with steroid withdrawal or steroid control were evaluated between 2003 and 2019. Clinical variables, treatment adherence, acute rejection, graft loss, and death were analyzed through hazard ratios, and Kaplan-Meier and multivariate analyses. Results:The study included 152 patients, 71.1% steroid withdrawal, mean follow-up 8.5 years, 64.5% structural abnormalities, and 81.6% deceased donor. At 12 years of transplant, event-free survival analysis for graft loss or death showed no significant difference between steroid withdrawal and control steroid treatment (85.9% vs.

Long‐term outcomes of two‐dose alemtuzumab induction in pediatric kidney transplantation

“…At 3 years post-transplant, the majority of children had seen improvements in their height z-score with greater gains in prepubertal children. This is similar to data reported by Gajardo et al 47…”

“…At 3 years post‐transplant, the majority of children had seen improvements in their height z ‐score with greater gains in prepubertal children. This is similar to data reported by Gajardo et al 47 . showing significant improvement in the height z ‐score of 1.09 ± 0.82 at 3 years post‐transplant with steroid‐free maintenance immunosuppression compared to an z ‐score improvement of 0.11 ± 0.9 in the steroid‐based immunosuppression children ( p < .001).…”

Evaluation of limited-sampling strategies to calculate AUC(0–24) and the role of CYP3A5 in Chilean pediatric kidney recipients using extended-release tacrolimus

“…Adolescence and young adulthood are considered critical periods with a high risk of graft loss due to bad adherence ( van Arendonk et al, 2013 ). Furthermore, previous studies in our center demonstrated that non-adherence was the main predictor of graft loss and death, turning immunosuppression monitoring into a primary priority to promote adherence in these patients ( Gajardo et al, 2021 ).…”

Association of HLA B‐ and T‐cell molecular mismatches with HLA antibodies, rejection, and graft survival in pediatric kidney transplantation

“…Alloimmunity is undoubtedly the pathophysiology of rejection. Rejection rates in pediatric populations are reported to be approximately 11% 58–60 in the first year after transplantation. However, the 1‐year rejection rate was 4% in our cohort, with a 5‐year rejection rate of 10%.…”