Ronghai Deng, Huanxi Zhang, Yitao Zheng, Longshan Liu, Qian Fu, Jun Li, Qingshan Huang, Huijiao Liu and Changxi Wang
First Affiliated Hospital-Sun Yat-sen University, China
Posters & Accepted Abstracts: J Nephrol Ther
Background: We combined the outcomes of all randomised control trials to investigate the safety and efficacy of steroid avoidance or withdrawal (SAW) regimens in paediatric kidney transplantation compared with steroid-based (SB) regimens. Methods: A systematic literature search of PubMed, Embase, Cochrane Library, the trials registry and BIOSIS previews was performed. A change in the height standardised Z-score from baseline (Ã?Â?HSDS) and acute rejection were the primary endpoints. Results: Eight reports from five randomised controlled trials were included, with a total of 528 patients. Sufficient evidence of a significant increase in the Ã?Â?HSDS was observed in the SAW group (mean difference (MD)=0.38, 95% confidence interval (CI) 0.07-0.68, P=0.01, particularly within the first year post-withdrawal (MD=0.22, 95% CI 0.10-0.35, P=0.0003) and in the prepubertal recipients (MD=0.60, 95% CI 0.21-0.98, P=0.002). There was no significant difference in the risk of acute rejection between the groups (relative risk=1.04, 95% CI 0.80-1.36, P=0.77). Conclusions: The SAW regimen is justified in selected paediatric renal allograft recipients because it provides significant benefits in post-transplant growth within the first year post-withdrawal with minimal effects on the risk of acute rejection, graft function, graft and patient survival within three years post-withdrawal. These selected paediatric recipients should have the following characteristics: Prepubertal; caucasian; with primary disease not related to immunological factors; de novo kidney transplant recipient and; with low panel reactive antibody.
Email: mddrh81@163.com
Journal of Nephrology & Therapeutics received 784 citations as per Google Scholar report
Spanish 
Chinese 
Russian 
German 
French 
Japanese 
Portuguese 
Hindi 