A prospective trial of steroid withdrawal after renal transplantation treated with cyclosporine and mizoribine in children: Results obtained between 1990 and 2003

被引：16

作者：

Motoyama, O

Hasegawa, A

Ohara, T

Satoh, M

Shishido, S

Honda, M

Tsuzuki, K

Kinukawa, T

Hattori, M

Ito, K

Ogawa, O

Yanagihara, T

Saito, K

Takahashi, K

Ohshima, S

机构：

[1] Toho Univ, Sch Med, Dept Pediat 1, Ota Ku, Tokyo 1438541, Japan

[2] Toho Univ, Sch Med, Dept Nephrol, Tokyo, Japan

[3] Tokyo Metropolitan Kiyose Childrens Hosp, Dept Urol, Tokyo, Japan

[4] Tokyo Metropolitan Kiyose Childrens Hosp, Dept Nephrol, Tokyo, Japan

[5] Social Insurance Chukyo Hosp, Dept Pediat, Nagoya, Aichi, Japan

[6] Social Insurance Chukyo Hosp, Dept Urol, Nagoya, Aichi, Japan

[7] Tokyo Womens Med Coll, Dept Pediat Nephrol, Tokyo 162, Japan

[8] Ogawa Clin, Miyazaki, Japan

[9] Niigata Prefectural Yoshida Hosp, Dept Pediat, Niigata, Japan

[10] Niigata Univ, Sch Med, Dept Urol, Niigata, Japan

[11] Nagoya Univ, Sch Med, Dept Urol, Nagoya, Aichi 466, Japan

来源：

PEDIATRIC TRANSPLANTATION | 2005年 / 9卷 / 02期

关键词：

renal transplantation; steroid withdrawal; children; cyclosporine; mizoribine;

D O I：

10.1111/j.1399-3046.2005.00255.x

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

A prospective trial of adrenocorticostertoid (steroid) withdrawal after pediatric renal transplantation was begun in 1990. Ninety-four pediatric renal transplant recipients were enrolled in our multicenter study. Immunosuppressive therapy with cyclosporine (CyA), methylprednisolone (MPL), and mizoribine (MZ) was started after transplantation. MPL was reduced to administration on alternate days in 69 patients (73.4%) and was withdrawn in 27 patients (28.7%). Rejection episodes occurred in nine patients (33.3%) after withdrawal of MPL. It occurred within 3 months after withdrawal of MPL in two patients and more than 6 months in the others. Among them, two patients lost the grafts. Thirteen-year patient survival rate and graft survival rate were 94.6 and 83.1%, respectively. Forty-four of the 94 patients reached their final height. Mean final height was 155.0 cm in males and 146.3 cm in females and their height standard deviation score was -2.6 s.d., the same as that at the time of transplantation. Management of growth retardation before transplantation and further reduction in the steroid dose after transplantation will increase the final height of children with chronic renal failure.

引用

页码：232 / 238

页数：7

共 26 条

[1] ADULT HEIGHT ACHIEVED IN CHILDREN AFTER KIDNEY-TRANSPLANTATION [J].

ASCHENDORFF, C ;

OFFNER, G ;

WINKLER, L ;

SCHIRG, E ;

HOYER, PF ;

BRODEHL, J .

AMERICAN JOURNAL OF DISEASES OF CHILDREN, 1990, 144 (10) :1138-1141

[2] Outcome after steroid withdrawal in pediatric renal transplant patients receiving tacrolimus-based immunosuppression [J].

Chakrabarti, P ;

Wong, HY ;

Scantlebury, VP ;

Jordan, ML ;

Vivas, C ;

Ellis, D ;

Lombardozzi-Lane, S ;

Hakala, TR ;

Fung, JJ ;

Simmons, RL ;

Starzl, TE ;

Shapiro, R .

TRANSPLANTATION, 2000, 70 (05) :760-764

[3]

CHAO SM, 1994, PEDIATR NEPHROL, V8, P62

[4] ADVANTAGES OF CYCLOSPORINE AS SOLE IMMUNOSUPPRESSIVE AGENT IN CHILDREN WITH TRANSPLANTED KIDNEYS [J].

GHIO, L ;

TARANTINO, A ;

EDEFONTI, A ;

MOCCIARO, A ;

GIANI, M ;

GUERRA, L ;

BERARDINELLI, L ;

VEGETO, A .

TRANSPLANTATION, 1992, 54 (05) :834-838

[5]

HODSON EM, 1989, TRANSPLANT P, V21, P1687

[6] FINAL HEIGHT AND ITS PREDICTIVE FACTORS AFTER RENAL-TRANSPLANTATION IN CHILDHOOD [J].

HOKKENKOELEGA, ACS ;

VANZAAL, MAE ;

VANBERGEN, W ;

DERIDDER, MAJ ;

STIJNEN, T ;

WOLFF, ED ;

DEJONG, RCJW ;

DONCKERWOLCKE, RA ;

KEIZERSCHRAMA, SMPFD ;

DROP, SLS .

PEDIATRIC RESEARCH, 1994, 36 (03) :323-328

[7]

INGULLI E, 1993, KIDNEY INT, V44, pS36

[8]

INGULLI E, 1994, PEDIAT RENAL TRANSPL, P221

[9]

*JAP SOC CLIN REN, 2003, JPN J TRANSPLANT, V38, P137

[10]

KLARE B, 1991, TRANSPLANT P, V23, P1013

← 1 2 3 →