Related Experiment Videos
Pediatric renal transplantation under tacrolimus-based immunosuppression
R Shapiro1, V P Scantlebury, M L Jordan
1Thomas E. Starzl Transplantation Institute, Division of Urologic Surgery, University of Pittsburgh, Pennsylvania 15213, USA.
Transplantation
|February 12, 1999
Summary
Tacrolimus-based immunosuppression shows good short- and medium-term results in pediatric kidney transplant patients. The treatment allows for steroid withdrawal, improves growth, and reduces rejection and PTLD incidence with experience.
Area of Science:
- Nephrology
- Immunology
- Pediatric Surgery
Background:
- Tacrolimus is a key immunosuppressant in adult and pediatric renal transplants.
- This study evaluated tacrolimus-based immunosuppression in 82 pediatric renal transplantations without antibody induction therapy.
Purpose of the Study:
- To assess the efficacy and safety of tacrolimus-based immunosuppression in pediatric renal transplant recipients.
- To evaluate patient and graft survival, medication withdrawal rates, growth outcomes, and complication incidence.
Main Methods:
- Retrospective analysis of 82 pediatric renal transplantations between 1989 and 1996.
- Tacrolimus-based immunosuppression without induction anti-lymphocyte antibody therapy.
- Follow-up averaged 4.0 years.
Main Results:
- 1- and 4-year patient survival: 99% and 94%; graft survival: 98% and 84%.
- 66% of patients withdrew from prednisone; 86% were off anti-hypertensives.
- Incidence of acute rejection decreased over time (63% to 23%); PTLD incidence was 9% (successfully treated).
Conclusions:
- Tacrolimus-based immunosuppression is effective in the short- and medium-term for pediatric renal transplants.
- Achieved steroid and anti-hypertensive withdrawal, improved growth, and reduced rejection and PTLD rates with experience.