Success of a steroid-minimization immunosuppression protocol for renal transplantation in the presence of donor-specific antibodies.
Steroid-minimization regimens have gained tremendous popularity for renal Tx in the recent past since they are associated with lower metabolic complications and other adverse effects related to long-term steroid exposure. Most such protocols have been restricted to low-risk recipients due to the concern for acute rejection with steroid-minimization. Herein, we report our experience in managing a child who received a positive flow cytometry cross-match living donor kidney transplant with low titer DSA and was successfully managed using a steroid-minimization drug regimen. The purpose of our report is to make pediatric transplant care providers aware of the feasibility of using a steroid-minimization immunosuppression regimen even in children who have traditionally been perceived to be at higher risk for immunologic complications, allowing successful avoidance of steroid toxicity.
Butani
Lavjay
L
Department of Pediatrics, University of California Davis Medical Center, Sacramento, CA 95817, USA. Lavjay.butani@ucdmc.ucdavis.edu
Perez
Richard V
RV
Gallay
Brian J
BJ
D000906:Antibodies / Q000737:chemistry; D017809:Fatal Outcome; D005434:Flow Cytometry / Q000379:methods; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000737:chemistry / Q000627:therapeutic use*; D007223:Infant; D016030:Kidney Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D013256:Steroids / Q000737:chemistry / Q000627:therapeutic use*; D013997:Time Factors
D000906:Antibodies; D007166:Immunosuppressive Agents; D013256:Steroids