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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
Consultar en UCrea Leer publicación
DAVID SAN SEGUNDO ARRIBAS
JUAN CARLOS RUIZ SAN MILLAN
EMILIO RODRIGO CALABIA
IÑIGO ROMON ALONSO
MANUEL ANTONIO ARIAS RODRIGUEZ
MARCOS LOPEZ HOYOS