Extended experience with a steroid minimization immunosuppression protocol in pediatric renal transplant recipients

Keith K. Lau, Gerre M. Berg, Yolanda G. Schjoneman, Richard V Perez, Lavjay Butani

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Purpose: To determine the safety and efficacy of a novel steroid minimization protocol after renal transplantation at a single Northern California center. Introduction: We have previously reported our experience on the short-term outcomes in eight children using our steroid minimization protocol. Herein, we present our ongoing experience in using this regimen in 20 children. Methods: Children receiving immunosuppression with a steroid minimization protocol at our center from 1/04 - 12/08 (Group 2) were retrospectively compared with 20 controls (Group 1). Results: At one-month follow-up, Group 2 was observed to have lower eGFR, hemoglobin, white cell count, and cholesterol. The incidence of adverse events during the first yr was comparable. Three patients in Group 1 displayed histological evidence of acute rejection, one patient in Group 2 developed humoral rejection; another patient in Group 2 had sub-clinical rejection. Surgical complications were observed in 20% of patients in both groups. While 10% of patients in Group 1 developed diabetes mellitus, none was observed in Group 2. Thirty and 40% of patients in Groups 1 and 2, respectively, suffered from infectious complications during the first yr. Conclusions: Our novel steroid minimization immunosuppression is safe in children and associated with no increased risk of rejection and infection.

Original languageEnglish (US)
Pages (from-to)488-495
Number of pages8
JournalPediatric Transplantation
Volume14
Issue number4
DOIs
StatePublished - Jun 2010

Keywords

  • Pediatrics
  • Renal transplantation
  • Steroid discontinuation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

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