Extended experience with a steroid minimization immunosuppression protocol in pediatric renal transplant recipients.
OBJECTIVE
To determine the safety and efficacy of a novel steroid minimization protocol after renal transplantation at a single Northern California center.


BACKGROUND
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.
Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
Keith K
KK
Lau
Gerre M
GM
Berg
Yolanda G
YG
Schjoneman
Richard V
RV
Perez
Lavjay
L
Butani
D000886:Anthropometry; D001706:Biopsy; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D012189:Retrospective Studies; D013256:Steroids / Q000008:administration & dosage*; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D013256:Steroids