Faculty Collaboration Database

Long-term outcome of a prospective trial of steroid withdrawal after kidney transplantation. Surgery 1999 Feb;125(2):155-9

Date

02/23/1999

Pubmed ID

10026748

DOI

10.1016/S0039-6060(99)70259-X

Scopus ID

2-s2.0-0032981052 (requires institutional sign-in at Scopus site)   30 Citations

Abstract

BACKGROUND: Steroid withdrawal (SW) after kidney transplantation is desirable to avoid associated serious side effects. We studied the long-term outcome of a group of kidney transplant recipients who underwent SW.

METHODS: Between 1991 and 1993, kidney transplant recipients (N = 12) who had posttransplantation diabetes were entered in a prospective trial of SW. These patients were compared with a demographically similar comparison cohort (N = 66). End points of the study were patient and graft survival, incidence of late acute and chronic rejection, and changes in diabetes management.

RESULTS: Previously published data from the SW group at 15 months of follow-up indicated improvement in diabetes control without any adverse effect on patient or graft actuarial survival. At long-term follow-up (mean, 56 months) the improvement in diabetes management was not detectable. The incidence of late acute rejection in SW and cohort groups was 42% and 8%, respectively (P = .006). Likewise, the incidence of chronic rejection in the SW versus cohort group was 42% and 12%, respectively (P = .014).

CONCLUSIONS: Although SW appeared to be successful initially, our long-term data indicate that SW significantly increases the risk of late acute rejection and chronic rejection episodes without benefits in posttransplantation diabetes management. Steroid withdrawal in patients with posttransplantation diabetes should be approached with caution.

Author List

Dunn TB, Asolati M, Holman DM, Raofi V, Jovanovic B, Pollak R, Benedetti E

Author

Ty Blink Dunn MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adult
Aged
Anti-Inflammatory Agents
Chronic Disease
Diabetes Mellitus
Female
Graft Rejection
Graft Survival
Humans
Hypoglycemic Agents
Insulin
Kidney Transplantation
Lipids
Male
Middle Aged
Prednisone
Prospective Studies
Substance Withdrawal Syndrome
Survival Analysis
Time Factors
Treatment Outcome