No occurrence of de novo HLA antibodies in patients with early corticosteroid withdrawal in a 5-year prospective randomized study

Transplantation. 2009 Feb 27;87(4):546-8. doi: 10.1097/TP.0b013e3181949d2e.

Abstract

The purpose of this study was to determine the effect of early corticosteroid cessation on the occurrence of de novo human leukocyte antigen (HLA) antibody posttransplant. Renal transplant recipients (n=37) were randomized to early corticosteroid withdrawal at day 7 posttransplant (n=21 patients), or to chronic steroids (n=16), all in combination with thymoglobulin as induction agent, tacrolimus and mycophenolic acid as maintenance therapy. To establish the time course of HLA antibody appearance, sera collected pretransplant and for up to 5 years posttransplant were screened for the appearance of HLA antibodies. In this 5-year longitudinal study, only one patient in the control group developed a de novo donor-specific HLA antibody. We conclude that renal transplant recipients on steroid withdrawal by the end of week 1 are not at higher risk for developing HLA antibodies compared with a standard steroid regimen up to 5 years posttransplant.

Trial registration: ClinicalTrials.gov NCT00650468.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Cadaver
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • HLA Antigens / immunology*
  • Histocompatibility Testing
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Isoantibodies / blood*
  • Kidney Transplantation / immunology*
  • Living Donors
  • Male
  • Middle Aged
  • Prospective Studies
  • Tissue Donors

Substances

  • Adrenal Cortex Hormones
  • HLA Antigens
  • Immunosuppressive Agents
  • Isoantibodies

Associated data

  • ClinicalTrials.gov/NCT00650468