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Patients whose renal function worsened and who did not respond to CNI<\/jats:styled-content> minimization had their CNI<\/jats:styled-content> discontinued. The clinical history of 35 pediatric heart transplant patients with significant renal insufficiency whose CNI<\/jats:styled-content> was discontinued was retrospectively analyzed. Data including serum creatinine and weight were collected before, at time of, and every 3\u20136\u00a0months after CNI<\/jats:styled-content> discontinuation. This was used to calculate an eGFR<\/jats:styled-content>. Cardiac allograft rejection and mortality data were also collected. CNI<\/jats:styled-content> discontinuation occurred 39 times in 35 patients. The median eGFR<\/jats:styled-content> significantly increased by 14 mL<\/jats:styled-content>\/min 3\u00a0months after CNI<\/jats:styled-content> discontinuation and the increase continued to be significant (P<\/jats:italic>\u2264.05) at 5\u00a0years. Freedom from rejection analysis showed no difference between graft rejection 2\u00a0years before versus after CNI<\/jats:styled-content> discontinuation (P<\/jats:italic>=.437). No mortality was associated with CNI<\/jats:styled-content> discontinuation. Immunosuppression free of CNI<\/jats:styled-content>s and corticosteroids appears to be a safe alternative in pediatric heart transplant patients with significant renal insufficiency. Furthermore, this strategy can significantly reverse renal insufficiency, even late after transplantation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.12808","type":"journal-article","created":{"date-parts":[[2016,9,23]],"date-time":"2016-09-23T05:04:49Z","timestamp":1474607089000},"source":"Crossref","is-referenced-by-count":7,"title":["Calcineurin inhibitor\u2010 and corticosteroid\u2010free immunosuppression in pediatric heart transplant patients"],"prefix":"10.1111","volume":"21","author":[{"given":"Caroline M.","family":"Sierra","sequence":"first","affiliation":[{"name":"School of Pharmacy Loma Linda University Loma Linda CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Tan","sequence":"additional","affiliation":[{"name":"Medical Center Loma Linda University Loma Linda CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jim","family":"Eguchi","sequence":"additional","affiliation":[{"name":"Children's Hospital Loma Linda 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