Sureshkumar KK, Marcus RJ, Chopra B. Role of steroid maintenance in sensitized kidney transplant recipients. World J Transplant 2015; 5(3): 102-109 [PMID: 26421263 DOI: 10.5500/wjt.v5.i3.102]
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
Retrospective Study
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Sureshkumar KK, Marcus RJ, Chopra B. Role of steroid maintenance in sensitized kidney transplant recipients. World J Transplant 2015; 5(3): 102-109 [PMID: 26421263 DOI: 10.5500/wjt.v5.i3.102]
World J Transplant. Sep 24, 2015; 5(3): 102-109 Published online Sep 24, 2015. doi: 10.5500/wjt.v5.i3.102
Role of steroid maintenance in sensitized kidney transplant recipients
Kalathil K Sureshkumar, Richard J Marcus, Bhavna Chopra
Kalathil K Sureshkumar, Richard J Marcus, Bhavna Chopra, Division of Nephrology and Hypertension, Department of Medicine, 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; Marcus RJ participated in research design, performance of the research and data analysis; Chopra B participated in data analysis and writing of the manuscript.
Institutional review board statement: IRB approval of the study protocol attached (Allegheny-Singer Research Institute).
Informed consent statement: This study was exempted from the need for informed consent (see attached IRB certification of exemption).
Conflict-of-interest statement: No conflict-of-interest to declare.
Data sharing statement: This study was performed using the OPTN/UNOS data base which is publically available.
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: February 24, 2015 Peer-review started: February 26, 2015 First decision: June 3, 2015 Revised: June 11, 2015 Accepted: August 13, 2015 Article in press: August 14, 2015 Published online: September 24, 2015 Processing time: 212 Days and 17.1 Hours
Core Tip
Core tip: This study critically evaluated the role of steroid maintenance in kidney transplant recipients (KTR) based on the level of sensitization by utilizing the Organ Procurement and Transplant Network/United Network of Organ Sharing database. In the multivariate model, we found an association between increased risk for death with functioning graft and steroid maintenance in KTRs who had peak-panel reactive antibody < 30% and received perioperative induction therapy followed by calcineurin inhibitor/mycophenolate mofetil maintenance. On the other hand, steroid maintenance was associated with improved death-censored graft survival without adversely impacting patient survival in KTRs with a peak PRA > 60%. No benefits of steroid maintenance were observed in older KTRs regardless of level of sensitization. These finding have clinical relevance and should be further evaluated in randomized clinical trials.
