Related Experiment Videos
Prednisone-free maintenance immunosuppression-a 5-year experience
Arthur J Matas1, Raja Kandaswamy, Kristen J Gillingham
1Department of Surgery, University of Minnesota, Minneapolis, USA. matas001@umn.edu
Summary
Kidney transplant recipients can achieve good long-term graft survival with prednisone-free immunosuppression. This approach significantly reduces prednisone-related side effects, improving patient outcomes.
Area of Science:
- Nephrology
- Transplantation Immunology
- Clinical Medicine
Background:
- Concerns exist regarding late allograft dysfunction and graft loss with prednisone-free immunosuppression in kidney transplant recipients.
- Prednisone is a common immunosuppressant with known significant side effects.
Purpose of the Study:
- To evaluate the 5-year outcomes of kidney transplant recipients on a prednisone-free maintenance immunosuppression protocol.
- To assess graft survival, patient survival, and the incidence of prednisone-related complications.
Main Methods:
- A prospective trial involving 589 kidney transplant recipients discontinuing prednisone on postoperative day 6.
- Long-term follow-up to assess actuarial survival rates and serum creatinine levels.
- Comparison of complication rates with historical controls.
Main Results:
- At 5 years, patient survival was 91%, and graft survival was 84%.
- Death-censored graft survival was 92%, acute rejection-free survival was 84%, and chronic rejection-free survival was 87%.
- Significantly lower rates of cataracts, posttransplant diabetes mellitus, avascular necrosis, and fractures were observed compared to historical controls.
Conclusions:
- Prednisone-free maintenance immunosuppression in kidney transplantation is associated with good 5-year graft outcomes.
- This protocol effectively minimizes prednisone-related side effects, enhancing overall patient well-being.
- Long-term graft function and survival can be maintained without chronic prednisone use.