{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:29:17Z","timestamp":1787938157420,"version":"build-2784847793"},"reference-count":46,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,10,23]],"date-time":"2021-10-23T00:00:00Z","timestamp":1634947200000},"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":["Pediatric Transplantation"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is a scarcity of long\u2010term data on steroid\u2010free immunosuppression using alemtuzumab in pediatric kidney transplantation (KTx). This study examines long\u2010term outcomes with alemtuzumab without steroid maintenance therapy in pediatric KTx.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From July 2005 to June 2015, 71 pediatric KTx recipients received alemtuzumab without steroid maintenance. They were followed from 4.1 to 14.1\u00a0years post KTx.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic>Patient survival<\/jats:italic>: One child expired with a functioning graft from post\u2010transplant lymphoproliferative disorder (PTLD). Patient survival was 98.6%.<\/jats:p><jats:p><jats:italic>Graft survival<\/jats:italic>: Eighteen grafts were lost (16 from chronic rejection). Graft survival at 5 and 10\u00a0years was 92.3% and 61.3%, respectively.<\/jats:p><jats:p><jats:italic>Rejection<\/jats:italic>: Twenty\u2010three <jats:italic>(<\/jats:italic>32.4%) patients were free from T\u2010cell\u2010mediated rejection (TCMR), 16 (22.5%) had &gt;3 episodes. Sixteen (22.5%) were treated for antibody\u2010mediated rejection (AMR).<\/jats:p><jats:p><jats:italic>Infection<\/jats:italic>: Twenty\u2010three children developed Epstein\u2010Barr virus (EBV), 5 developed cytomegalovirus (CMV), and 20 developed BK virus infection. Four (5.6%) developed PTLD. Twenty\u2010two (31.0%) required treatment for neutropenia.<\/jats:p><jats:p><jats:italic>Growth parameters<\/jats:italic>: Mean height and weight increased by 0.56 and 0.69 SDS (standard deviation score), respectively. Body mass index increased by 5.1\u00a0kg\/m<jats:sup>2<\/jats:sup> at 10\u00a0years. Less than 40% required antihypertensive medications at all\u2010time points.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Alemtuzumab, without corticosteroid maintenance, offers 98.6% patient survival at 14\u00a0years with five and 10\u2010year graft survival of 92.3% and 61.3%, respectively. TCMR and AMR requiring treatment were 67.4% and 22.5%, respectively. CMV, EBV, and BK viremia rates were 7.0%, 32.4%, and 28.2%, respectively. Thirty\u2010one percent were treated for neutropenia; 5.6% developed PTLD. There were improvements in growth parameters and blood pressure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14173","type":"journal-article","created":{"date-parts":[[2021,10,23]],"date-time":"2021-10-23T16:11:08Z","timestamp":1635005468000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Steroid\u2010free maintenance immunosuppression using alemtuzumab in pediatric kidney transplantation: Long\u2010term longitudinal follow\u2010up"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8475-973X","authenticated-orcid":false,"given":"Ashokkumar","family":"Jain","sequence":"first","affiliation":[{"name":"Division of Transplantation Department of Surgery The Pennsylvania State University College of Medicine Hershey Pennsylvania 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