Early Corticosteroid Avoidance in Kidney Transplant Recipients Receiving ATG‐F Induction: 5‐Year Actual Results of a Prospective and Randomized Study. Issue 11 (19th September 2014)

• Record Type: Journal Article
• Authors: Cantarovich, D.; Rostaing, L.; Kamar, N.; Ducloux, D.; Saint‐Hillier, Y.; Mourad, G.; Garrigue, V.; Wolf, P.; Ellero, B.; Cassuto, E.; Albano, L.; Völp, A.; Soulillou, J.‐P.; the FRANCIA Study Trial Investigators Group
• Is Part Of: American journal of transplantation. Volume 14:Issue 11(2014:Nov.)
• Page Start: 2556
• Page End: 2564
• Publication Date: 2014-09-19
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.12866
• Languages: English
• ISSNs: 1600-6135

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ajt12866-sec-0001" sec-type="section"> <p>One hundred ninety‐seven patients received anti‐T‐lymphocyte globulins Fresenius, mycophenolate mofetil and delayed cyclosporine, and were randomized to ≥6‐month corticosteroids (+CS; n = 99) or no CS (−CS; n = 98). One‐ and five‐year actual graft survival (censored for death) was 93.2% and 86.4% in the +CS group versus 94.9% and 89.8% in the −CS group (5‐year follow‐up, p = 0.487). Freedom from clinical rejection was 86.9% and 81.8% versus 74.5% and 74.5% (p = 0.144), respectively, at 1 and 5 years; 5‐year freedom from biopsy‐proven rejection was 88.9% versus 83.7% (p = 0.227). More late first rejections occurred in the +CS group. Significantly lower 5‐year graft survival in patients experiencing rejection was observed for +CS (55.6% vs. 92.0%; p = 0.005) with 8/18 versus 2/25 graft losses. Renal function at 5 years was stable and comparable (median serum creatinine, 159 vs. 145 µmol/L; creatinine clearance, 53.5 vs. 56.6 mL/min). More +CS patients developed diabetes, dyslipidemia and malignancies. Rejections in −CS patients occurred early after transplantation and did not impair long‐term renal function. In patients receiving CS, rejections occurred later and with a higher risk for subsequent graft failure. A similar and not inferior 5‐year efficacy profile and a reduced morbidity were observed in CS‐free patients compared to patients who received CS for at least 6 months.</p> </sec> </abstract>