| dc.description.abstract | Steroids have been a cornerstone in renal transplant immu-
nosuppression. New immunosuppressive drugs have led to protocols
using early steroid withdrawal or complete avoidance. A prospective
protocol in 23 pediatric renal transplant (ages 2–14 yr) who received
decreasing steroid doses stopping at day 7 post-Tx, FK, and MMF were
compared with a CsA, AZT, historically matched steroid-based control
group. Basiliximab was used in two doses. Anthropometric, biochemical
variables, AR rates, and CMV infection were evaluated and compared
using Student s t-test and regression analysis. A better growth pattern
2 was seen in steroid withdrawal group. GFR rate and serum glucose
were similar in both groups. Total serum cholesterol levels were signi-
ficantly lower in steroid withdrawal group. The incidence of AR at
12 months was 4.3% in steroid withdrawal group vs. 8.6% in steroid-
based group (p = ns). No difference in CMV infection was observed.
Hemoglobin levels were low during the first months in both groups;
reached normal values after six months. SBP became higher at
12 months in steroid-based group. Patient and graft survival was 98%
in both groups at one-yr post-transplant. Early steroid withdrawal was
efficacious, safe, and did not increase risk of rejection, preserving
optimal growth, renal function, and reducing cardiovascular risk fac-
tors. | |
