Steroid withdrawal increases risk of acute rejection but reduces infection: A meta-analysis of 1681 cases in renal transplantation

doi:10.1016/j.transproceed.2006.06.039

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	Steroid withdrawal increases risk of acute rejection but reduces infection: A meta-analysis of 1681 cases in renal transplantation
	Tan, JY; Zhao, N; Wu, TX; Yang, KH; Zhang, JD; Tian, JH; Liu, YL; Wang, KJ; Chen, F; Li, SF
	2006-09
会议日期	NOV 29-DEC 02, 2005
会议地点	Karachi, PAKISTAN
卷号	38
期号	7
DOI	10.1016/j.transproceed.2006.06.039
页码	2054-2056
英文摘要	Objective. To evaluate the safety of steroid withdrawal in renal transplantation recipients. Methods. These following databases were searched: Medline (1966 to September 2005), OVID (1966 to 2004), Embase (1984 to 2004), Cochrane library (issue 4, 2005), Highwire (1849 to September 2005), American Transplant Congress (2005), Chinese Biomedicine database (CBM 1994 to 2005). The safety was measured by the following factors: patient and graft survival, acute rejection, chronic rejection, infection, serum creatinine. We performed meta-analysis by using Revman 4.2.7. Results. Nine randomized clinical trials were identified to have a steroid withdrawal and a steroid continuing group. They included 1681 patients: 845 with steroid withdrawal and 836 with continuing steroid. The risk of acute rejection after steroid withdrawal was two times higher than steroid-continuing group (RR 2.05; 95% confidence interval [CI]: 1.54, 2.72; P <.00001), while the incidence of opportunistic infection and urinary tract infection of steroid withdrawal group were lower than the control group (RR 0.80; 95%CI 0.64, 1.00; P =.05 vs RR 0.74; 95%CI, 0.60, 0.92; P =.004, respectively). The graft and patient survivals, chronic rejection, and serum creatinine were similar to the steroid continuing group. Conclusion. Steroid withdrawal can significantly increase the risk of acute rejection episodes, but reduces the incidence of infection to a certain extent. To prophylaxis against serious infection, steroid withdrawal is worth considering using a sufficient immunosuppressive regimen. The key point is to balance the benefit and harm for the individual recipient.
会议录	TRANSPLANTATION PROCEEDINGS
会议录出版地	NEW YORK
学科主题	Immunology ; Surgery ; Transplantation
语种	英语
ISSN号	0041-1345
WOS记录号	WOS:000240888400031
内容类型	会议论文
源URL	[http://ir.lzu.edu.cn/handle/262010/183013]
专题	基础医学院_会议论文
通讯作者	Li, YP (reprint author), Sichuan Univ, W China Hosp, Lab Transplant Engn & Immunol, Minist Hlth, Chengdu 610041, Peoples R China.
推荐引用方式 GB/T 7714	Tan, JY,Zhao, N,Wu, TX,et al. Steroid withdrawal increases risk of acute rejection but reduces infection: A meta-analysis of 1681 cases in renal transplantation[C]. 见:. Karachi, PAKISTAN. NOV 29-DEC 02, 2005.