{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T19:10:00Z","timestamp":1762542600240,"version":"3.41.2"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,1,24]],"date-time":"2017-01-24T00:00:00Z","timestamp":1485216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Long\u2010term use of steroids results in predictable secondary effects that can lead to increased morbidity and mortality. In this study, we present 10\u00a0years worth of data of early steroid withdrawal (<jats:styled-content style=\"fixed-case\">ESW<\/jats:styled-content>) immunosuppression consisting of mycophenolate, sirolimus, and tacrolimus. From 2003 to 2013, 563 kidney transplant recipients were weaned off steroids prior to discharge. We compared outcomes with that of our 65 historical controls maintained on steroids. We analyzed graft and patient survival and determined the incidence of steroid\u2010related comorbidities such as hypertension, hypercholesterolemia, diabetes, coronary artery disease, and weight gain. Patients on<jats:styled-content style=\"fixed-case\">ESW<\/jats:styled-content>maintenance immunosuppression had improved patient and graft survival compared to controls. (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>: 0.23;<jats:italic>P<\/jats:italic>\u2264.011, 0.57;<jats:italic>P<\/jats:italic>=.026). Rates of biopsy\u2010proven acute rejection were not different among both groups (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>: 1.24;<jats:italic>P<\/jats:italic>=.610). Incidence of post\u2010transplant diabetes were reduced but not statistically significant (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 0.67;<jats:italic>P<\/jats:italic>=.138). Additionally, the development of hypertension (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 0.86,<jats:italic>P<\/jats:italic>\u2264.01), hypercholesterolemia (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>: 0.82;<jats:italic>P<\/jats:italic>=.027),<jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content>(<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>: 0.43;<jats:italic>P<\/jats:italic>=.002), and &gt;20\u00a0lbs. weight gain (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>: 0.29;<jats:italic>P<\/jats:italic>\u2264.01) was significantly improved over 10\u00a0years following initiation of<jats:styled-content style=\"fixed-case\">ESW<\/jats:styled-content>protocols. Early steroid withdrawal in renal transplant recipients results in improved patient and graft survival as well as better rates of post\u2010transplant comorbid conditions.<\/jats:p>","DOI":"10.1111\/ctr.12878","type":"journal-article","created":{"date-parts":[[2016,11,26]],"date-time":"2016-11-26T06:52:42Z","timestamp":1480143162000},"source":"Crossref","is-referenced-by-count":13,"title":["Early steroid withdrawal results in improved patient and graft survival and lower risk of post\u2010transplant cardiovascular risk profiles: A single\u2010center 10\u2010year experience"],"prefix":"10.1111","volume":"31","author":[{"given":"Reynold I.","family":"Lopez\u2010Soler","sequence":"first","affiliation":[{"name":"Division of Surgery Section of Transplantation Albany Medical Center Albany NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Surgery Albany Medical College Albany NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Martinolich","sequence":"additional","affiliation":[{"name":"Department of Surgery Albany Medical College Albany NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Surgery Cleveland Clinic Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashar","family":"Ata","sequence":"additional","affiliation":[{"name":"Department of Surgery Albany Medical College Albany NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos","family":"Chandolias","sequence":"additional","affiliation":[{"name":"Division of Surgery Section of Transplantation Albany Medical Center Albany NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Conti","sequence":"additional","affiliation":[{"name":"Division of Surgery Section of Transplantation Albany Medical Center Albany NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,1,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1111\/j.1399-0012.1994.tb00245.x","article-title":"Steroid\u2010related complications in the cyclosporin era","volume":"8","author":"Fryer J","year":"1994","journal-title":"Clin 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of late corticosteroid withdrawal after renal transplantation in patients exposed to tacrolimus and\/or mycophenolate mofetil: meta\u2010analysis of randomized controlled trials","volume":"2","author":"Ali AK","year":"2011","journal-title":"Int J Organ Transplant Med"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13195"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trim.2008.08.011"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2004.12.083"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V461300"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0146523"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-6143.2003.00010.x"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2007111202"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2011.01335.x"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181c518cc"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfv214"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000000983"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e31816f1cd3"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000120949.86038.62"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3182921995"}],"container-title":["Clinical 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