Rapid discontinuation of prednisone in kidney transplant recipients from at-risk subgroups: an OPTN/SRTR analysis
Although rapid stopping of prednisone (RDP) after kidney transplantation continues to be effective in low-risk recipients, there’s worry about RDP use within recipients at elevated risk for rejection or recurrent disease. Using SRTR, we compared outcomes for RDP versus maintenance prednisone-treated recipients for those adult first and second transplants (n = 169 479) and also the following first transplant subgroups: Black (AA) highly sensitized individuals having a potentially recurrent disease and pediatric recipients. For those adult first LD and DD transplants, RDP was connected with better patient and graft survival. For those LD subgroups, RDP and maintenance prednisone were connected concentrating on the same patient, graft, and dying-censored (Electricity) graft survival. For first transplant DD subgroups, RDP was connected with better patient survival in AA, individuals with potentially recurrent disease, and pediatric recipients graft survival with RDP was better in AAs. For adult second DD transplants, RDP was connected with worse Electricity-graft survival. Importantly, for those variations, the result size was small. Except for NSC-10023 second DD transplants, RDP protocols may be used without decreasing patient or graft survival for subgroups of first DD and LD kidney transplant recipients as well as for second LD transplant recipients, at elevated chance of rejection or recurrent disease.