PURPOSE: RDP after KTx is associated with increased early rejection; no decrease in medium‐term patient (PS) or graft survival (GS); and significantly decreased prednisone‐related side effects. Concern remains that RDP will be associated with increased late graft loss.

METHODS: Between 10/1/1999 and 6/1/2015, 1553 adult 1st KTx (1021 LD; 532 DD) were done utilizing RDP (discontinuation of prednisone on POD #6). Outcomes were compared between RDP and standard long‐term prednisone therapy (control). We studied: a) actuarial 15-year PS, GS, and death‐censored graft survival (DC-GS); and b) for patients with 5 year GS, outcomes between 5‐15 years.

RESULTS: a) PS for LD recipients was similar among the RDP and control groups; for DD, PS was significantly better for the RDP group (p<0.01; Fig 1a). GS for patients on RDP (vs controls) was significantly better for both LD (p<0.05) and DD (p<0.01) recipients. Similarly, DC‐GS for patients on RDP was significantly better for both LD (p<0.05) and DD (p<0.01) recipients. Ten-year RDP outcomes were similar to contemporaneous SRTR data (AJT, 2013). b) For LD and DD recipients with 5‐year graft survival, subsequent outcomes (5‐15 years) were similar between RDP and controls (Fig 1b). eGFR in RDP-treated groups (DD or LD) was initially greater than eGFR in control groups (Fig 2). However, this difference dissipates over time. Causes of graft loss did not differ between groups.

CONCLUSION: In 1st KTx, RDP (vs long-term prednisone) is not associated with increased rates of late graft functional deterioration or loss.

CITATION INFORMATION: Serrano O, Kandaswamy R, Gillingham K, Payne W, Dunn T, Chinnakotla S, Finger E, Ibrahim H, Kukla A, Spong R, Issa N, Pruett T, Matas A. Rapid Discontinuation of Prednisone (RDP) in Kidney Transplant (KTx) Recipients: 15-Year Outcomes. Am J Transplant. 2016;16 (suppl 3).

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