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Steroid avoidance in renal transplantation

Amy Lightner1, Waldo Concepcion, Paul Grimm

  • 1Department of Surgery, Stanford University, Stanford, California, USA.

Current Opinion in Organ Transplantation
|August 17, 2011
PubMed

Insights

Steroid-avoidance protocols show promise for pediatric kidney transplants, improving outcomes and growth without increasing complications. Long-term data is still needed to determine the optimal approach.

Area of Science:

  • Pediatric Nephrology
  • Transplantation Immunology

Background:

  • Steroid-avoidance protocols are increasingly used in pediatric renal transplantation due to steroid-related adverse effects.
  • These protocols, initially successful in adults, are now being evaluated in pediatric populations.

Purpose of the Study:

  • To assess patient and graft outcomes in pediatric renal transplant recipients on steroid-avoidance protocols.
  • To evaluate the safety, efficacy, and long-term effects of these protocols, including viral complications, PTLD, metabolic benefits, and growth.

Main Methods:

  • Review of current literature and initial results from steroid-avoidance protocols in pediatric renal transplant recipients.
  • Analysis of safety profiles, graft survival, viral complications, PTLD incidence, metabolic profiles, and growth patterns.

Main Results:

  • Initial findings indicate that steroid-avoidance protocols are safe and effective for pediatric kidney transplant patients.
  • These protocols are associated with improved graft survival, better metabolic profiles, and enhanced linear growth.
  • No significant increase in viral complications or post-transplant lymphoproliferative disease (PTLD) was observed.

Conclusions:

  • Steroid-avoidance protocols represent a promising strategy for pediatric renal transplantation.
  • Further long-term data from large, prospective randomized trials are necessary.
  • Optimal steroid-avoidance protocols for this population have not yet been definitively established.
Abstract

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