DETERMINANTS OF LONG-TERM ALLOGRAFT FUNCTION FOLLOWING STEROID WITHDRAWAL IN RENAL-TRANSPLANT RECIPIENTS

We retrospectively measured changes in serum creatinine concentration as estimates of changes in renal function in 96 renal transplant recip ients who were withdrawn from steroid therapy, maintained on cyclospor ine and azathioprine, and followed for 1 to 5 years. Multivariate anal yses were used to assess the influence of cyclosporine dose and blood levels, azathioprine dose, age, sex, race, diabetes, HLA match and mis match, PRA, and history of rejection following steroid withdrawal on l ong-term allograft function. Results indicate that acute rejection and cyclosporine dose are the major factors influencing long-term renal f unction after steroid withdrawal. In this setting, there is an inverse relationship between cyclosporine dose and serum creatinine concentra tion for up to 5 years. Optimal renal function is achieved in patients receiving more than 5.5 mg/kg of cyclosporine per day at the time of steroid withdrawal.