Steroid Withdrawal for Pancreas after Kidney Transplantation in Recipients on Maintenance Prednisone Immunosuppression

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Abstract

Methods.

Pancreas transplantation was performed using systemic venous drainage and enteric exocrine drainage. Regardless of preoperative immunosuppression, all patients received induction with antithymocyte globulin, a brief taper of intravenous solumedrol over four to five days, maintenance therapy with tacrolimus and sirolimus and either resumption of chronic maintenance steroids or complete withdrawal of steroids.

Results.

A total of 30 PAK transplants were performed in 29 recipients and divided into two groups: continuation of chronic steroids (n=10) or steroid-free (n=19). One pancreas allograft was lost and there was a single mortality in the steroid free group. There was no significant difference in renal function or incidence of infections.

Conclusion.

Steroids can be safely withdrawn following pancreas after kidney transplantation for recipients already on maintenance prednisone in the setting of rabbit antithymocyte globulin induction and tacrolimus and sirolimus maintenance immunosuppression.

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