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
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