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  • Title: Early steroid withdrawal in a renal transplant cohort treated with tacrolimus, mycophenolate mofetil and basiliximab.
    Author: Andrade-Sierra J, Rojas-Campos E, Cardona-Muñoz E, Evangelista-Carrillo LA, Puentes-Camacho A, Lugo-López O, Gómez B, Valdespino C, Cerrillos I, Medina-Pérez M, Jalomo B, Nieves JJ, Sandoval M, Ramos-Solano F, Monteón-Ramos F, Cueto-Manzano AM.
    Journal: Nefrologia; 2014; 34(2):216-22. PubMed ID: 24658197.
    Abstract:
    BACKGROUND: Acute rejection and graft function have not been completely clarified in early-steroid-withdrawal (ESW) patients. The objective of this study was to compare the effect of early steroid withdrawal on GFR, graft survival/rejection in recipients in a cohort treated with tacrolimus/mycophenolate mofetil compared to a control cohort. MATERIAL AND METHOD: Retrospective cohort, in 60 low immunological risk recipients between December 2005 and July 2010. Study cohort (ESW-C N=32), steroid withdrawal was carried out after 5 days, while they were receiving tacrolimus/mycophenolate mofetil. The control cohort (C-C, N=28) received prednisone/tacrolimus/mycophenolate mofetil. Clinical, biochemical and histological variables were assessed at baseline and after 3, 6, and 12 months of follow-up. Kaplan-Meier and the Cox proportional hazards model were used to assess survival. Comparisons between cohorts were carried out by the Student's t and c2 tests. RESULTS: At follow-up, C-C displayed significantly higher systolic (125 ± 10 vs. 114 ± 8) and diastolic (81 ± 8 vs. 72 ± 7) blood pressure, serum glucose (96 ± 13 vs. 86 ± 10), triglycerides (177 ± 61 vs. 129 ± 34), total (183 ± 43 vs. 148 ± 34) and LDL-cholesterol (100 ± 22 vs. 87 ± 25). C-C had a higher proportion of antihypertensive (57 vs. 13%), and statins (27 vs. 9%) use. eGFR was better in ESW-C than in C-C (85.4 ± 20.6 vs. 70.6 ± 17.0, p=.004). AR frequency was lower in ESW-C. CONCLUSIONS: Graft survival, GFR, AR rate and metabolic profile were better in the ESW-C than in C-C.
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