2026-04-13T00:48:17Zhttps://recercat.cat/oai/request

oai:recercat.cat:2445/1777782025-12-05T12:30:08Zcom_2072_1057col_2072_478798col_2072_478916col_2072_478917

00925njm 22002777a 4500 dc Hernández, Domingo author Alonso Titos, Juana author Vázquez, Teresa author León, Myriam author Caballero, Abelardo author Cobo, María Angeles author Sola, Eugenia author López, Verónica author Ruiz Esteban, Pedro author Cruzado, Josep Ma. author Sellarés, Joana author Moreso, Francesc author Manonelles, Anna author Torío, Alberto author Cabello, Mercedes author Delgado Burgos, Juan author Casas, Cristina author Gutiérrez, Elena author Jironda, Cristina author Kanter, Julia author Serón, Daniel author Torres, Armando author 2021-05-28T09:29:37Z 2021-05-28T09:29:37Z 2021-05-07 2021-05-28T06:49:58Z The impact of corticosteroid withdrawal on medium-term graft histological changes in kidney transplant (KT) recipients under standard immunosuppression is uncertain. As part of an open-label, multicenter, prospective, phase IV, 24-month clinical trial (ClinicalTrials.gov, NCT02284464) in low-immunological-risk KT recipients, 105 patients were randomized, after a protocol-biopsy at 3 months, to corticosteroid continuation (CSC, n = 52) or corticosteroid withdrawal (CSW, n = 53). Both groups received tacrolimus and MMF and had another protocol-biopsy at 24 months. The acute rejection rate, including subclinical inflammation (SCI), was comparable between groups (21.2 vs. 24.5%). No patients developed dnDSA. Inflammatory and chronicity scores increased from 3 to 24 months in patients with, at baseline, no inflammation (NI) or SCI, regardless of treatment. CSW patients with SCI at 3 months had a significantly increased chronicity score at 24 months. HbA1c levels were lower in CSW patients (6.4 +/- 1.2 vs. 5.7 +/- 0.6%; p = 0.013) at 24 months, as was systolic blood pressure (134.2 +/- 14.9 vs. 125.7 +/- 15.3 mmHg; p = 0.016). Allograft function was comparable between groups and no patients died or lost their graft. An increase in chronicity scores at 2-years post-transplantation was observed in low-immunological-risk KT recipients with initial NI or SCI, but CSW may accelerate chronicity changes, especially in patients with early SCI. This strategy did, however, improve the cardiovascular profiles of patients. Trasplantament renal Biòpsia Corticosteroides Kidney transplantation Biopsy Adrenocortical hormones Clinical Relevance of Corticosteroid Withdrawal on Graft Histological Lesions in Low-Immunological-Risk Kidney Transplant Patients