Motoyama Osamu, Hasegawa Akira, Aikawa Atsushi, Shishido Seiichirou, Honda Masataka, Tsuzuki Kazuo, Kinukawa Tsuneo, Hattori Motoshi, Ogawa Osamu, Yanagihara Toshio, Saito Kazuhide, Takahashi Kota, Ohshima Shinichi
Department of Nephrology, Toho University Medical Center, Omori Hospital, Tokyo, Japan.
Pediatr Transplant. 2012 Feb;16(1):78-82. doi: 10.1111/j.1399-3046.2011.01614.x. Epub 2011 Nov 29.
A prospective trial of corticosteroid (steroid) withdrawal after pediatric renal transplantation was started in 1990. Fifty-eight recipients with functioning grafts reached their final height. They were transplanted at a mean age of 10.7 yr. Immunosuppressive therapy with CyA, MP, and MZ was started after transplantation. MP was reduced to an alternate-day dose in 49 patients and was withdrawn in 23. Their mean height SDS was -2.4 at the time of transplantation and -2.1 at their final height. Mean final height was 157.9 cm in men and 147.6 cm in women. In 18 patients who had been withdrawn from MP for more than two yr before reaching final height, mean age at transplantation was 8.9 yr. Their mean height SDS of -2.2 at the time of transplantation increased to -1.6 at their final height (p = 0.02), and mean final height was 163.8 cm in men and 147.8 cm in women. The height SDS in all 58 patients was maintained during the immunosuppressive therapy with steroid minimization, and final height SDS increased in recipients older than five yr at transplantation with steroid withdrawal.
