{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T23:16:40Z","timestamp":1774307800617,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,8,7]],"date-time":"2019-08-07T00:00:00Z","timestamp":1565136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Obese transplant recipients (BMI\u00a0\u2265\u00a030\u00a0kg\/m<jats:sup>2<\/jats:sup>) have decreased posttransplant patient and graft survival compared with their nonobese counterparts. At the same time, many prednisone\u2010related side effects (eg, new\u2010onset diabetes) are similar to those associated with obesity. Using SRTR data, we studied outcomes associated with prednisone\u2010free maintenance immunosuppression (rapid discontinuation of prednisone\u2014RDP). Between January 1, 2000, and December 31, 2014, 44\u00a0635 first transplant recipients with BMI\u00a0\u2265\u00a030\u00a0kg\/m<jats:sup>2<\/jats:sup> had a first kidney transplant (28\u00a0176 DD; 16\u00a0459, LD); 12,994 (29%)\u00a0were discharged from the hospital on a prednisone\u2010free protocol. We compared outcomes to those discharged on a protocol incorporating maintenance prednisone (intention\u2010to\u2010treat analysis). RDP\u2010treated obese first DD recipients had significantly better patient survival (HR, 0.88; CI, 0.81\u20100.96) and graft survival (HR, 0.93; CI, 0.88\u20100.99) compared with their counterparts on maintenance immunosuppression. Although not statistically significant, the same trends were seen for LD recipients. For both DD and LD recipients, there was no difference between groups for death\u2010censored graft survival, suggesting that the benefit of RDP was due to improved patient survival. Our findings suggest that kidney transplant recipients with BMI\u00a0\u2265\u00a030\u00a0kg\/m<jats:sup>2<\/jats:sup> benefit from a protocol that incorporates RDP.<\/jats:p>","DOI":"10.1111\/ctr.13668","type":"journal-article","created":{"date-parts":[[2019,7,16]],"date-time":"2019-07-16T11:20:05Z","timestamp":1563276005000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prednisone\u2010free maintenance immunosuppression in obese kidney transplant recipients"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9957-639X","authenticated-orcid":false,"given":"Arthur J.","family":"Matas","sequence":"first","affiliation":[{"name":"Division of Transplantation, Department of Surgery, Medical School University of Minnesota Minneapolis MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5459-9579","authenticated-orcid":false,"given":"David M.","family":"Vock","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, School of Public Health University of Minnesota Minneapolis MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,8,7]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"CD005632","article-title":"Steroid avoidance or withdrawal for kidney transplant recipients","volume":"1","author":"Pascual J","year":"2009","journal-title":"Cochrane Database Syst 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