Lindsey Turner, David M Vock, Erika Helgeson, Raja Kandaswamy, Richard Spong, Timothy Pruett, Erik Finger, Vanessa Humphreville, Srinath Chinnakotla, Andrew Adams, Rasha El-Rifai, Karthik Ramanathan, Arthur J Matas
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Twenty-Year Kidney Transplant Outcomes With Prednisone-Free Maintenance Immunosuppression: A Matched Control Analysis.
There has been concern about long-term outcomes of kidney transplant recipients treated with prednisone-free maintenance immunosuppression. We studied 20-year outcomes for recipients treated with discontinuation of prednisone <1 week posttransplant (rapid discontinuation of prednisone [RDP]) compared with contemporaneous matched controls treated with maintenance prednisone (MP). First and second, adult living donor (LD) and deceased donor (DD) kidney transplant recipients from 1999 to 2009, treated with RDP were matched-using data from the Scientific Registry of Transplant Recipients-with contemporaneous controls, from large transplant centers, who were treated with MP. A total of 361 DD recipients treated with RDP were matched with 1805 treated with long-term MP. A total of 763 LD recipients treated with RDP were matched with 2289 treated with long-term MP. DD recipients treated with RDP had significantly better recipient survival (p = 0.02); there was no difference in graft or death-censored graft survival. For LD recipients, there was no difference between groups for all outcomes. Kidney transplant recipients treated with RDP had better or similar long-term outcomes as those treated with long-term MP. RDP should be considered for the majority of kidney transplant recipients.
期刊介绍：
Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored.
Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include:
Immunology and immunosuppression;
Patient preparation;
Social, ethical, and psychological issues;
Complications, short- and long-term results;
Artificial organs;
Donation and preservation of organ and tissue;
Translational studies;
Advances in tissue typing;
Updates on transplant pathology;.
Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries.
Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.
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