A prospective randomized trial of steroid-free maintenance regimens in kidney transplant recipients - An interim analysis

Authors

Raja Kandaswamy, University of Minnesota Twin Cities
J. Keith Melancon, University of Minnesota Twin Cities
Ty Dunn, University of Minnesota Twin Cities
Miguel Tan, University of Minnesota Twin Cities
Vincent Casingal, University of Minnesota Twin Cities
Abhinav Humar, University of Minnesota Twin Cities
William D. Payne, University of Minnesota Twin Cities
Rainer W.G. Gruessner, University of Minnesota Twin Cities
David L. Dunn, University of Minnesota Twin Cities
John S. Najarian, University of Minnesota Twin Cities
David E.R. Sutherland, University of Minnesota Twin Cities
Kristen J. Gillingham, University of Minnesota Twin Cities
Arthur J. Matas, University of Minnesota Twin Cities

Document Type

Journal Article

Publication Date

6-1-2005

Journal

American Journal of Transplantation

Volume

5

Issue

6

DOI

10.1111/j.1600-6143.2005.00885.x

Keywords

Immunosuppression; Kidney transplant; Prospective; Śteroid-free

Abstract

We compared three maintenance immunosuppressive regimens in a rapid discontinuation of prednisone protocol. From March 1, 2001, through December 31, 2003, 239 first and second kidney transplant recipients (166 LD; 73 DD) were randomized. All recipients were treated with Thymoglobulin; all received steroids intraoperatively and for 5 days postoperatively. Randomization was to cyclosporine-mycophenolate mofetil (n = 85); high-level tacrolimus (TAG) (8-12 ng/mL)-low-level sirolimus (SRL) (3-7 ng/mL) (n = 72); or low-level TAG (3-7 ng/mL)-high-level SRL (8-12 ng/mL) (n = 82). We found no difference at 24 months between groups in patient, graft, death-censored graft, or acute rejection-free graft survival, or in kidney function. Wound complications were more common in SRL-treated recipients (p = 0.02); we found no other differences between groups in complication rates. Our data suggest that excellent patient and graft survival and low rejection rates can be obtained using a variety of maintenance protocols without prednisone. Copyright © Blackwell Munksgaard 2005.

APA Citation

Kandaswamy, R., Melancon, J., Dunn, T., Tan, M., Casingal, V., Humar, A., Payne, W., Gruessner, R., Dunn, D., Najarian, J., Sutherland, D., Gillingham, K., & Matas, A. (2005). A prospective randomized trial of steroid-free maintenance regimens in kidney transplant recipients - An interim analysis. American Journal of Transplantation, 5 (6). http://dx.doi.org/10.1111/j.1600-6143.2005.00885.x