Steroid withdrawal in kidney allograft recipients

被引:3
|
作者
Adesina, Sanni [1 ,2 ]
Alkhudhayri, Abdullah [1 ,2 ,3 ]
Patel, Jyodi Kiran [1 ,2 ]
Naufal, Mary [1 ,2 ]
Geara, Abdallah [4 ]
Azzi, Jamil [1 ,2 ]
机构
[1] Brigham & Womens Hosp, Transplantat Res Ctr, Div Renal, Boston, MA 02115 USA
[2] Harvard Univ, Sch Med, Childrens Hosp, Boston, MA 02115 USA
[3] King Faisal Specialist Hosp & Res Ctr, Dept Surg, Riyadh 12713, Saudi Arabia
[4] W Virginia Univ, Sch Med, Dept Med, Div Nephrol, Bridgeport, WV 26330 USA
关键词
acute rejection; allograft; calcineurin; cyclosporine; glomerulonephritis; immunosuppression; interstitial fibrosis and tubular atrophy; mycophenolate mofetil; new onset diabetes after transplantation; surveillance biopsy; RENAL-TRANSPLANT RECIPIENTS; FREE MAINTENANCE IMMUNOSUPPRESSION; EARLY CORTICOSTEROID WITHDRAWAL; TOTAL BODY IRRADIATION; LONG-TERM; PROTOCOL BIOPSIES; RECEIVING SIROLIMUS; THERAPY; CYCLOSPORINE; MULTICENTER;
D O I
10.1586/1744666X.2014.946406
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
This review highlights the aggregate of knowledge obtained from the temporal trend of kidney transplant immune suppression. We will discuss the burden of steroid side effects and their impact on quality of life in kidney allograft recipients, which have led to minimizing steroid exposure. Issues arising since the inception of the concept of steroid withdrawal will be discussed, along with how they have continually led to a shift in research focus on this subject matter. The usefulness of surveillance biopsies and how further elucidation of the pathophysiology of interstitial fibrosis and tubular atrophy could contribute to improving long-term allograft outcomes will also be discussed. We will elaborate on the role of calcineurin inhibitor minimization alongside steroid withdrawal in improving long-term graft survival. Future expectations of subsequent studies with a view to improving overall kidney allograft outcomes by eliminating attendant problems associated with steroids will also be covered.
引用
收藏
页码:1229 / 1239
页数:11
相关论文
共 50 条
  • [1] Steroid avoidance or withdrawal in kidney transplantation
    Pascual, Julio
    CURRENT OPINION IN ORGAN TRANSPLANTATION, 2011, 16 (06) : 600 - 605
  • [2] Steroid Withdrawal or Avoidance after Kidney Transplant
    Wright, Linda S.
    NEPHROLOGY NURSING JOURNAL, 2014, 41 (06) : 613 - 617
  • [3] Early Steroid Withdrawal Compared With Steroid Avoidance Correlates With Graft Failure Among Kidney Transplant Recipients With an History of Diabetes
    Cantarovich, D.
    Hodemon-Corne, B.
    Trebern-Launay, K.
    Giral, M.
    Foucher, Y.
    Dantan, E.
    TRANSPLANTATION PROCEEDINGS, 2013, 45 (04) : 1497 - 1502
  • [4] Impact of Early Conversion From Tacrolimus to Sirolimus on Chronic Allograft Changes in Kidney Recipients on Rapid Steroid Withdrawal
    Heilman, Raymond L.
    Cortese, Cherise
    Geiger, Xochiquetzal J.
    Younan, Kerrie
    Wadei, Hani M.
    Mai, Martin L.
    Reddy, Kunam S.
    Gonwa, Thomas A.
    TRANSPLANTATION, 2012, 93 (01) : 47 - 53
  • [5] Steroid Withdrawal in Kidney Transplantation: The Subgroup Fallacy
    Steiner, Robert W.
    TRANSPLANTATION, 2011, 91 (05) : E27 - E28
  • [6] Early Steroid Withdrawal in Kidney Transplant Recipients: CON
    Aziz, Fahad
    Parajuli, Sandesh
    KIDNEY360, 2025, 6 (02): : 187 - 190
  • [7] Influence of African-American Ethnicity on Acute Rejection after Early Steroid Withdrawal in Primary Kidney Transplant Recipients
    Padiyar, A.
    Augustine, J. J.
    Bodziak, K. A.
    Aeder, M.
    Schulak, J. A.
    Hricik, D. E.
    TRANSPLANTATION PROCEEDINGS, 2010, 42 (05) : 1643 - 1647
  • [8] A Comparative Effectiveness Analysis of Early Steroid Withdrawal in Black Kidney Transplant Recipients
    Taber, David J.
    Hunt, Kelly J.
    Gebregziabher, Mulugeta
    Srinivas, Titte
    Chavin, Kenneth D.
    Baliga, Prabhakar K.
    Egede, Leonard E.
    CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2017, 12 (01): : 131 - 139
  • [9] Steroid Withdrawal Based on Lymphocyte Sensitivity to Endogenous Steroid in Renal Transplant Recipients
    Takeuchi, Hironori
    Matsuno, Naoto
    Hirano, Toshihiko
    Gulimire, Muhetaer
    Hama, Koichiro
    Nakamura, Yuki
    Iwamoto, Hitoshi
    Toraishi, Tatsunori
    Kawaguchi, Takashi
    Okuyama, Kiyoshi
    Unezaki, Sakae
    Nagao, Takeshi
    BIOLOGICAL & PHARMACEUTICAL BULLETIN, 2011, 34 (10) : 1578 - 1583
  • [10] Induction Treatment with Rabbit Antithymocyte Globulin versus Basiliximab in Renal Transplant Recipients with Planned Early Steroid Withdrawal
    Martin, Spencer T.
    Roberts, Keri L.
    Malek, Sayeed K.
    Tullius, Stefan G.
    Vadivel, Nidyanandh
    De Serres, Sacha
    Grafals, Monica
    Elsanjak, Abdelaziz
    Filkins, Beth Anne
    Chandraker, Anil
    Gabardi, Steven
    PHARMACOTHERAPY, 2011, 31 (06): : 566 - 573