African American renal transplant recipients benefit from early corticosteroid withdrawal under modern immunosuppression.
African Americans have historically been considered high-risk renal transplant recipients due to increased rejection rates and reduced long-term graft survival. Modern immunosuppression has reduced rejections and improved graft survival in African Americans and may allow successful corticosteroid withdrawal. Outcomes in 56 African Americans were compared to 56 non-African Americans enrolled in early withdrawal protocols. Results are reported as African American versus non-African American. Acute rejection at 1 year was 23% and 18% (P = NS), while patient and graft survival was 96% versus 98% and 91% versus 91% (P = NS), respectively. In conclusion, early withdrawal in African Americans is associated with acceptable rejection rates and excellent patient and graft survival, indicating that the risks and benefits of early withdrawal are similar between African Americans and non-African Americans. Additional followup is needed to determine long-term renal function, graft survival, and cardiovascular risk in African Americans with early steroid withdrawal.
Boardman
R E
RE
Division of Transplantation University of Cincinnati, Cincinnati, Ohio.
Alloway
R R
RR
Alexander
J W
JW
Buell
J F
JF
Cardi
M
M
First
M R
MR
Hanaway
M T
MT
Munda
R
R
Rogers
C C
CC
Roy-Chaudhury
P
P
Susskind
B
B
Trofe
J
J
Woodle
E S
ES
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D001741:Black or African American; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D004334:Drug Administration Schedule; D006084:Graft Rejection / Q000453:epidemiology / Q000276:immunology; D006085:Graft Survival / Q000187:drug effects / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology / Q000401:mortality / Q000502:physiology*; D016019:Survival Analysis; D013997:Time Factors
D000305:Adrenal Cortex Hormones; D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents