Background Long-term use of steroid with large dosage might cause many adverse effects in kidney transplant patients; reducing steroid dosage to a low level for maintenance is helpful in avoiding the side-effects, but...Background Long-term use of steroid with large dosage might cause many adverse effects in kidney transplant patients; reducing steroid dosage to a low level for maintenance is helpful in avoiding the side-effects, but meanwhile, acute rejection may rise to be a main concern. The present research monitored the immune function changes and the incidence of acute rejection and infection after rapid steroid reduction to investiclate the safety of this strategy.Methods A prospective trial was conducted, using tacrolimus and mycophenolate mofetil as the basic immunosuppressive regimen, in addition to antibody induction with basiliximab. Corticosteroid dosage was rapidly reduced to 10 mg/d seven days post-transplantation in the experimental group, and the standard corticosteroid therapy was employed in the control group. Patient immunity was monitored by the Immune Cell Function Assay pre- and two weeks post-transplantation. The incidence of acute rejection and infection were compared between the experimental and control group.Results Comparison of intracellular adenosine triphosphate （iATP） values detected two weeks post-transplantation for the control group （（324±45） ng/ml） and the experimental group （（345±91） ng/ml） did not reveal a significant difference （P 〉0.05）. The incidence of acute rejection was analogous between groups （P 〉0.05）, while an increased incidence of infection was observed in the control group （53% （n=-16）） versus the experimental group （22% （n=-6）, P 〈0.05）. Overall, recipients in the control group had longer and more recurrent infections than those in the experimental group （P 〈0.05）. Patients in the control group had a lower immune response （（235±35） ng/ml） than those in the experimental group （（286±16） ng/ml） when infection occurred （P 〈0.05）.Conclusion Rapid reduction of steroid early after kidney transplantation does not lead to a significant rise in patient immunity. It is a safe and effective therapy for kidney transplant patients.展开更多
文摘Background Long-term use of steroid with large dosage might cause many adverse effects in kidney transplant patients; reducing steroid dosage to a low level for maintenance is helpful in avoiding the side-effects, but meanwhile, acute rejection may rise to be a main concern. The present research monitored the immune function changes and the incidence of acute rejection and infection after rapid steroid reduction to investiclate the safety of this strategy.Methods A prospective trial was conducted, using tacrolimus and mycophenolate mofetil as the basic immunosuppressive regimen, in addition to antibody induction with basiliximab. Corticosteroid dosage was rapidly reduced to 10 mg/d seven days post-transplantation in the experimental group, and the standard corticosteroid therapy was employed in the control group. Patient immunity was monitored by the Immune Cell Function Assay pre- and two weeks post-transplantation. The incidence of acute rejection and infection were compared between the experimental and control group.Results Comparison of intracellular adenosine triphosphate （iATP） values detected two weeks post-transplantation for the control group （（324±45） ng/ml） and the experimental group （（345±91） ng/ml） did not reveal a significant difference （P 〉0.05）. The incidence of acute rejection was analogous between groups （P 〉0.05）, while an increased incidence of infection was observed in the control group （53% （n=-16）） versus the experimental group （22% （n=-6）, P 〈0.05）. Overall, recipients in the control group had longer and more recurrent infections than those in the experimental group （P 〈0.05）. Patients in the control group had a lower immune response （（235±35） ng/ml） than those in the experimental group （（286±16） ng/ml） when infection occurred （P 〈0.05）.Conclusion Rapid reduction of steroid early after kidney transplantation does not lead to a significant rise in patient immunity. It is a safe and effective therapy for kidney transplant patients.
