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Abstract: tIntroduction: Steroid withdrawal in renal transplantation is desirable to avoid their adverseeffects. However, by decreasing the immunosuppression, could lead to an increased risk forthe development of HLA-Abs.Objective: Evaluate the relationship between steroid withdrawal and development of HLA-Abs in renal transplantation.Methods: We analyzed sera by Luminex from 182 kidney transplants performed from 1998to 2011, before and two years after transplantation. All the patients had a pretransplantPRA (panel reactive of antibodies) <20% by complement-dependent cytotoxicity (CDC) andmaintenance immunosuppression with tacrolimus and mycophenolate mofetil (MMF). Wecompared a group of steroid withdrawal at 7 months (group-I; n = 130) and another controlwith non-withdrawal (group-II; n = 52).Results: 22 patients (16.9%) in group-I and 11 patients in group-II (21.1%) had HLA-Abs aftertwo years (pNS). Despite excluding patients with PRA >20%, we detected HLA-Abs pretrans-plant by Luminex in 11.5% of patients in both groups, of which, 66.6%, versus 53% (p 0.058),developed new specificities, with a similar percentage of donor specific antibodies (DSA) inboth groups (33.33% vs 36.36%), pNS. In the subgroup without pretransplant HLA-Abs (group-I; n = 115, group-II; n = 45), 6.08% developed de novo HLA-Abs, being DSA 3.4% (Group-I) versus7.69% in group II with 3.84% DSA (pNS).Conclusions: Steroid withdrawal at 7 months of renal transplantation does not entail a higherrisk in terms of HLA-Abs development in patients without pretransplant HLA-Abs andtreatment with tacrolimus and MMF, although larger studies are needed to confirm thesefindings.
Fuente: Nefrologia. 2017; 37(4): 415-422
Editorial: Plus Medical
Año de publicación: 2017
Nº de páginas: 8
Tipo de publicación: Artículo de Revista
DOI: 10.1016/j.nefro.2017.02.002
ISSN: 0211-6995,1989-2284
Consultar en UCrea Leer publicación
MONFÁ, ELENA
DAVID SAN SEGUNDO ARRIBAS
JUAN CARLOS RUIZ SAN MILLAN
SANABRIA, JUDITH
ALBINES, ZOILA
EMILIO RODRIGO CALABIA
IÑIGO ROMON ALONSO
ASENSIO, ESTHER
MANUEL ANTONIO ARIAS RODRIGUEZ
MARCOS LOPEZ HOYOS
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