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Sutherland SLL et al. – The failure rate of steroid–free immunosuppression among selective pediatric patients undergoing renal transplantation is low. Patients maintaining steroid–free immunosuppression have better allograft survival and function than those requiring conversion to steroid–based therapy. The most common reasons for failure of steroid–free immunosuppression are recalcitrant or recurrent allograft rejection and recurrent GN; the role of conversion to steroid–based immunosuppression after episodes of acute rejection and recurrent GN requires additional analysis.

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