{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T04:45:50Z","timestamp":1790484350569,"version":"4.1.0"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,10]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract.<\/jats:title>\n                    <jats:p>\n                      Since the publication of previous meta-analyses of cyclosporine (CsA) and prednisone withdrawal in renal transplant recipients, several additional randomized controlled trials with longer follow-up have been reported. Currently, in nine prednisone withdrawal trials (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 1461), the proportion of patients with acute rejection was increased by 0.14 (95% confidence interval = 0.10 to 0.17,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). In nine prednisone withdrawal trials (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 1899), the relative risk (RR; RR = 1.0 indicates no risk) of graft failure after withdrawal was also increased (RR = 1.40; range, 1.09 to 1.70,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.012). There was no evidence of between-study heterogeneity for either acute rejection or graft failure in the prednisone withdrawal trials by a \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      test (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05). In 10 CsA withdrawal trials (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 1049), the proportion of patients with acute rejection was increased by 0.11 (0.07 to 0.15,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). In 12 trials (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 1151), the RR of graft failure after CsA withdrawal was 1.06 (95% confidence interval, 0.82 to 1.29,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.646), but a \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      test indicated that there was study heterogeneity. However, there was no evidence of heterogeneity in the six studies (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 632) with at least 4.0 yr (5.8 \u00b1 1.7) of follow-up (RR = 0.92; range, 0.64 to 1.20,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.569) or in the seven trials (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 962) published in peer-reviewed journals (RR = 0.95; range, 0.70 to 1.20\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.682). Finally, in three trials (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 259) that compared CsA and prednisone withdrawal, there was a nonsignificant trend for less graft failure with CsA withdrawal (RR = 0.63; range, 0.08 to 1.16,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.190). Thus, unlike prednisone withdrawal, CsA withdrawal in select patients seems to impart little risk of long-term graft failure.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1681\/asn.v11101910","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T14:04:00Z","timestamp":1619618640000},"page":"1910-1917","source":"Crossref","is-referenced-by-count":324,"title":["A Meta-Analysis of Immunosuppression Withdrawal Trials in Renal Transplantation"],"prefix":"10.1681","volume":"11","author":[{"given":"BERTRAM L.","family":"KASISKE","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HARINI A.","family":"CHAKKERA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"THOMAS A.","family":"LOUIS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JENNIE Z.","family":"MA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","container-title":["Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00001751-200010000-00016","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T19:27:06Z","timestamp":1786130826000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00001751-200010000-00016"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,10]]},"references-count":0,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2000]]}},"URL":"https:\/\/doi.org\/10.1681\/asn.v11101910","relation":{},"ISSN":["1046-6673"],"issn-type":[{"value":"1046-6673","type":"print"}],"subject":[],"published":{"date-parts":[[2000,10]]}}}