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

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

Research output: Contribution to journalArticle

88 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1529-1536
Number of pages8
JournalAmerican Journal of Transplantation
Volume5
Issue number6
DOIs
StatePublished - Jun 2005
Externally publishedYes

Fingerprint

Sirolimus
Steroids
Maintenance
Graft Survival
Prednisone
Kidney
Mycophenolic Acid
Transplants
Tacrolimus
Immunosuppressive Agents
Random Allocation
Cyclosporine
Wounds and Injuries
Transplant Recipients

Keywords

  • Immunosuppression
  • Kidney transplant
  • Prospective
  • Śteroid-free

ASJC Scopus subject areas

  • Immunology

Cite this

A prospective randomized trial of steroid-free maintenance regimens in kidney transplant recipients - An interim analysis. / Kandaswamy, Raja; Melancon, J. Keith; Dunn, Ty; Tan, Miguel; Casingal, Vincent; Humar, Abhinav; Payne, William D.; Gruessner, Rainer W G; Dunn, David L.; Najarian, John S.; Sutherland, David E R; Gillingham, Kristen J.; Matas, Arthur J.

In: American Journal of Transplantation, Vol. 5, No. 6, 06.2005, p. 1529-1536.

Research output: Contribution to journalArticle

Kandaswamy, R, Melancon, JK, Dunn, T, Tan, M, Casingal, V, Humar, A, Payne, WD, Gruessner, RWG, Dunn, DL, Najarian, JS, Sutherland, DER, Gillingham, KJ & Matas, AJ 2005, 'A prospective randomized trial of steroid-free maintenance regimens in kidney transplant recipients - An interim analysis', American Journal of Transplantation, vol. 5, no. 6, pp. 1529-1536. https://doi.org/10.1111/j.1600-6143.2005.00885.x
Kandaswamy, Raja ; Melancon, J. Keith ; Dunn, Ty ; Tan, Miguel ; Casingal, Vincent ; Humar, Abhinav ; Payne, William D. ; Gruessner, Rainer W G ; Dunn, David L. ; Najarian, John S. ; Sutherland, David E R ; Gillingham, Kristen J. ; Matas, Arthur J. / A prospective randomized trial of steroid-free maintenance regimens in kidney transplant recipients - An interim analysis. In: American Journal of Transplantation. 2005 ; Vol. 5, No. 6. pp. 1529-1536.
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