engleski

Impact of early steroid withdrawal (ESW) on progression of chronic biopsy scores after kidney transplantation

Long-term effects of ESW on development of chronic pathohistology changes in kidney allograft is unclear. In this study we compared chronic scores on protocol biopsies in Caucasian kidney recipients(N=41) without DGF with ESW vs. continuous steroids on top of CNI and MMF. Induction consisted of IL-2RA or ATG. Protocol biopsies were done on day 0 and 1 year afer transplant. Chronic scores (ci, ct, cg, mm, cv and ah) were analyzed by Banff' 97 classification. ESW was not associated with changes in ci, ct, cg, mm and cv scores, but slight progression of ah score was noticed in ESW group(0.49±0.51 vs. 0.21±0.41 ; p=0.02). In multivariate analysis including recipient age and gender, donor age, type of donation (living or deceased) and type of transplant (kidney or kidney/pancreas), ESW was independently associated with progression of ah score (p=0.049). In conclusion, ESW may cause progression of ah score during first 12 months postransplant, without impact on other chronic scores.

early steroid withdrawal; chronic scores; kidney transplantation

doi:10.1053/j.ajkd.2011.02.209