title: Steroid avoidance in renal transplantation.
abstract: OBJECTIVE
  The recent surge in the use of steroid-avoidance protocols for pediatric renal transplant recipients has been fueled by the numerous adverse side effects of steroids and development of alternatives for successful immunosuppression. Steroid-avoidance protocols were first attempted in the adult population, and with positive outcomes, pediatrics soon followed. As more pediatric patients are placed on steroid-avoidance protocols, we must begin answering several important questions such as patient and graft outcome, safety profiles of various steroid-avoidance induction protocols, viral complications and incidence of transplant lymphoproliferative disease (PTLD), metabolic benefits, and the affect of steroid minimization on growth.
  
  
  RESULTS
  Initial results from steroid-avoidance protocols show these protocols are safe and effective with improved graft survival, metabolic profiles, and linear growth without an increase in viremia or PTLD.
  
  
  CONCLUSIONS
  Although initial results are promising, there is still a lack of long-term data from large, prospective randomized trials, and there is not enough data to determine the optimal steroid-avoidance protocol for pediatric renal transplant recipients.
authors.affiliation: Department of Surgery, Stanford University, Stanford, California, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Lightner
authors.forename: Waldo
authors.initials: W
authors.lastname: Concepcion
authors.forename: Paul
authors.initials: P
authors.lastname: Grimm
mesh_terms: D000075202:Contraindications; D006084:Graft Rejection / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D011379:Prognosis; D013256:Steroids
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids