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. 2012 Nov;16(7):704-10.
doi: 10.1111/j.1399-3046.2012.01714.x. Epub 2012 May 11.

Graft loss due to recurrent disease in pediatric kidney transplant recipients on a rapid prednisone discontinuation protocol

Blanche M Chavers  1 , Michelle N Rheault, Kristen J Gillingham, Arthur J Matas
Affiliations

Graft loss due to recurrent disease in pediatric kidney transplant recipients on a rapid prednisone discontinuation protocol

Blanche M Chavers et al. Pediatr Transplant. 2012 Nov.

Abstract

Recurrent disease is the fourth most common cause of graft loss (GL) in pediatric KTx recipients. We studied the incidence of recurrent disease and GL due to recurrent disease in pediatric KTx recipients on a RDP protocol. Between 2002 and 2010, we performed 74 KTxs in patients aged 5-18 yr using an RDP protocol, 25 (34%) were at risk of recurrence of primary disease. Outcomes were compared to 69 historical controls (18 [26%] at risk of recurrence), KTx between 1996 and 2000. Follow-up period was 39 ± 25 months in RDP and 124 ± 38 months in controls. The incidence of recurrent disease at three yr post-KTx was 16% in RDP and 28% in controls (p = NS). Mean time to recurrent disease was 22 ± 26 months in RDP and 46 ± 48 months in controls (p = 0.54). Nine (12%) grafts were lost in the RDP group (1-recurrence) and 32 (46%) in the control group (4-recurrence). Time to GL was 85 months in the RDP recipient and 46 ± 21 months in controls. An RDP protocol in pediatric KTx recipients may not be associated with increased risk of graft loss due to recurrent disease.

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Conflict of interest statement

DISCLOSURE

The authors of this manuscript have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Actuarial uncensored and censored graft survival rates by type of steroid protocol. RDP, rapid discontinuation of prednisone; rates were censored for death with a functioning graft. P= NS, uncensored and censored graft survival (Log rank test).
Figure 2
Figure 2
Actuarial recurrent disease free survival rates by type of steroid protocol. RDP, rapid discontinuation of prednisone. P= 0.42 (Log rank test).
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Comment in

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