Asian Transplantation Week 2017Kidney TransplantationSteroid Withdrawal Using Everolimus in ABO-Incompatible Kidney Transplant Recipients With Post-Transplant Diabetes Mellitus
Section snippets
Subjects and Study Design
We performed a retrospective, observational, cohort study of 33 de novo consecutive adult ABOi living donor kidney transplant recipients who underwent transplantation at Jichi Medical University Hospital between January 2013 and April 2017. This study was conducted in accordance with the principles of the Declarations of Helsinki and Istanbul and approved by the institutional review board.
Immunosuppressive Therapy
All ABOi recipients received immunosuppressive therapy for induction with Tac (0.1 mg/kg/d), MMF (30
Patient Characteristics
Before transplantation, no significant differences were observed between the EVR and steroid groups in patient characteristics such as sex, age, dialysis duration, donor-specific antigen-positive rate, living unrelated donor rate, CMV IgG-positive rate, and anti-donor-A/B antibody rate (Table 1). Conversely, the glomerulonephritis rate as the primary cause of end-stage renal disease was significantly higher in the steroid group than in the EVR group because patients with glomerulonephritis were
Discussion
In the present study, we investigated the outcomes of steroid withdrawal using EVR in ABOi kidney transplant recipients to determine whether conversion from steroid to EVR reduces the incidence of PTDM and CMV infection. Our results indicate that this new immunosuppressive protocol using conversion from steroid to EVR is effective in improving PTDM and CMV infection in ABOi kidney transplant recipients.
Steroid withdrawal for kidney transplantation is an attractive protocol because it can avoid
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Cited by (4)
Advancement in preoperative desensitization therapy for ABO incompatible kidney transplantation recipients
2023, Transplant ImmunologyManagement of metabolic alterations in adult kidney transplant recipients: A joint position statement of the Italian Society of Nephrology (SIN), the Italian Society for Organ Transplantation (SITO) and the Italian Diabetes Society (SID)
2020, Nutrition, Metabolism and Cardiovascular DiseasesCitation Excerpt :We could not find any published reports on the effects of reducing the dose of tacrolimus, CsA or corticosteroids; replacing tacrolimus or CsA with MMF or azathioprine; reducing the dose or discontinuing a mTORi on PTDM. One small retrospective, non-controlled trial showed that switching patients with PTDM from methylprednisolone to everolimus on top of tacrolimus and MMF did not worsen HbA1c over time [45]. An extension of this trial showed a significant decrease in HbA1c levels 9 months after conversion from methylprednisolone to everolimus [46].
Does steroid-free immunosuppression improve the outcome in kidney transplant recipients compared to conventional protocols?
2021, World Journal of TransplantationRapamycin for longevity: Opinion article
2019, Aging