Sureshkumar KK, Hussain SM, Thai NL, Ko TY, Nashar K, Marcus RJ. Impact of steroid maintenance on the outcomes in first-time deceased donor kidney transplant recipients: Analysis by induction type. World J Transplant 2014; 4(3): 188-195 [PMID: 25346892 DOI: 10.5500/wjt.v4.i3.188]
Corresponding Author of This Article
Kalathil K Sureshkumar, MD, FRCP (Glasgow), FASN, Division of Nephrology and Hypertension, Department of Medicine, Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA 15212, United States. ksureshk@wpahs.org
Research Domain of This Article
Transplantation
Article-Type of This Article
Original Article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Sep 24, 2014; 4(3): 188-195 Published online Sep 24, 2014. doi: 10.5500/wjt.v4.i3.188
Impact of steroid maintenance on the outcomes in first-time deceased donor kidney transplant recipients: Analysis by induction type
Kalathil K Sureshkumar, Sabiha M Hussain, Ngoc L Thai, Tina Y Ko, Khaled Nashar, Richard J Marcus
Kalathil K Sureshkumar, Sabiha M Hussain, Tina Y Ko, Khaled Nashar, Richard J Marcus, Divisions of Nephrology and Hypertension, Department of Medicine, Allegheny General Hospital, Pittsburgh, PA 15212, United States
Ngoc L Thai, Abdominal Transplantation, Allegheny General Hospital, Pittsburgh, PA 15212, United States
Author contributions: Sureshkumar KK participated in research design, performance of the research, data analysis and writing of the manuscript; Hussain SM participated in research design and data analysis; Thai NL participated in research design and data analysis; Ko TY and Nashar K participated in data analysis; Marcus RJ participated in research design, performance of the research and data analysis.
Supported by Health Resources and Services Administration Contract 231-00-0115
Correspondence to: Kalathil K Sureshkumar, MD, FRCP (Glasgow), FASN, Division of Nephrology and Hypertension, Department of Medicine, Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA 15212, United States. ksureshk@wpahs.org
Telephone: +1-412-3593319 Fax: +1-412-3594136
Received: March 24, 2014 Revised: June 5, 2014 Accepted: July 25, 2014 Published online: September 24, 2014
Core Tip
Core tip: This study critically looked at outcomes in a large recent cohort of first time deceased donor kidney transplant recipients from the Organ Procurement and Transplant Network/United Network of Organ Sharing database to assess the impact of triple maintenance immunosuppression after receiving various induction therapies. In multivariate analysis, we found an increased risk for death with functioning graft when steroid maintenance was added to calcineurin inhibitor/mycophenolate mofetil based regimen in patients who received powerful induction with rabbit-antithymocyte globulin (r-ATG), an effect that persisted even when patients were split into high and low immune risk groups. Based on these finding we feel that, one has to be cautious while maintaining intense immunosuppression by adding steroid to a calcineurin inhibitor/mycophenolate mofetil regimen in kidney transplant recipients who were selected for r-ATG induction.
