[Purpose] Several steroid early withdrawal protocols (SEWD) have been attempted in recent decades to avoid steroid related adverse effects among kidney transplant recipients. However, there have been few reports to describe complete steroid avoidance using basiliximab induction. In this study we investigated long-term outcomes of kidney transplant with SEWD protocol with basiliximab induction.

[Materials and Methods]60 living-donor kidney transplant recipients were enrolled in this study. The immunosuppression protocol consisted of tacrolimus, mycophenolate mofetil and 2 dose of basiliximab. Steroid was withdrawn at 3 days after operation in 28 recipients (SEWD group, follow period 99±39 M) and continued in 32 (Control group, follow period 67±38 M). The followings were compared between two groups: eGFR (estimated glomerular filtration rate), incidence of acute T-cell mediated rejection (ATMR) within a year after operation, chronic antibody mediated rejection (CAMR), pathological findings and graft survival between the two groups. Furthermore, we evaluated the steroid related adverse effects including cardiovascular event, hypertension, diabetic mellitus, hyperlipidemia and osteoporosis. Pathological findings were evaluated by Banff's classification.

[Results]The incidence of biopsy-confirmed ATMR and CAMR was comparable between two groups (ATMR: SEWD 25% vs Control 16%, CAMR: 11 vs 6%). The 3-year and 5-year graft survival was 100% and 100% in SEWD group, and 97% and 97% in control group (figure). Frequency of e steroid related adverse effects were statistically similar in both groups: cardiovascular event (0vs3%), hypertension (4vs9%), hyperlipidemia (14vs19%), diabetic mellitus (18vs13%). Furthermore, pathological scores and osteoporosis had no significant difference between the two groups.

[Conclusions]SEWD and steroid based protocol had similar impact on recipient's graft function and complications. These results suggest that SEWD could be a feasible option for kidney transplantation. However, further follow-up periods are required to clarify whether SEWD decrease steroid related complication for long term.

CITATION INFORMATION: Takada Y, Hotta K, Iwami D, Higuchi H, Hirose T, Sasaki H, Shinohara N. Clinical Outcomes of Kidney Transplant Recipients by Steroid Early Withdraw Protocol with Basiliximab Induction. Am J Transplant. 2017;17 (suppl 3).

« Back to 2017 American Transplant Congress