Non-Prednisone Regimen Safe and Effective for Pediatric Kidney Transplant Patients
Approximately 60 percent of newly transplanted pediatric kidney transplant patients in the U.S. are maintained on a prednisone-based immunosuppression regimen. However, in addition to its many other potential adverse effects, chronic prednisone exposure may slow growth and development in children, which is especially concerning in children whose kidney failure may have already adversely affected their growth and development.
Sharon Bartosh, MD, director of the UW Health pediatric renal transplant program and professor at University of Wisconsin School of Medicine and Public Health, has been offering a non-prednisone regimen since 2004. Originally a research protocol approved by the Institutional Review Board, and FDA-supervised, her team has completed more than 30 successful cases since that time, and Dr. Bartosh is very pleased with the results.
"Unlike many prednisone-treated children who have characteristic body habitus and facial features, our children look completely normal, are growing beautifully and are doing well with their transplant," says Dr. Bartosh.
The protocol consists of two doses of a unique immunosuppressive agent, alemtuzumab, during the transplant hospitalization, followed by mycophenolate mofetil and tacrolimus administered as outpatient medications. Candidates for this regimen are generally low-risk children who are receiving their first transplant, either from a living or a deceased donor, and who are at low risk for disease recurrence.
According to Dr. Bartosh, "the UW Health Pediatric Transplant Program is the only center in the region offering this protocol, making it very unique compared to what is being done in most of the transplant community."