EARLY STEROID WITHDRAWAL IN RENAL TRANSPLANTATION: ELDERLY PATIENTS AND RECIPIENTS OF 6AG MATCHED KIDNEYS CONSTITUTE A “LOW RISK” GROUP FOR ACUTE REJECTION

Abstract

P269 Aims: To date, reported experiences with early corticosteroid withdrawal (CSWD) in renal transplantation (Tx) have not examined populations that may be at “low risk” (LR) for acute rejection. Moreover, the few historical studies of CSWD that included low risk patients did not compare “low risk” (LR) populations to “normal risk” (NR) populations. The purpose of this study was to compare experience with early CSWD in defined groups of LR and NR pts. Methods: LR was defined as > 60 years of age or recipients of 6 Ag matched cadaver or living donor (LD) kidneys. NR was defined as age <60, non-6 Ag matched kidney recipients, primary Tx recipients, with current and peak PRA < 25%. Immunosuppression included calcineurin inhibitors (CI) in all pts, sirolimus (67% of pts), MMF (87% of pts), and CSWD within 7 days posttransplant. Induction therapy is outline in the table. Results: Demographic, immunologic risk, rejection, pt /raft survival, and DGF data is presented in the table.FigureThese results indicate that substantial differences exist between the defined LR and NR populations with respect to acute rejection. Conclusions: In addition to high risk populations for acute rejection, low risk and normal risk populations can also be defined that have differential risks for acute rejection. These results have important implications for design of CSWD clinical trials andf for interpretation and reporting of acute rejection rates in CSWD studies.