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Grenda R – The Stanford study showed that a complete steroid avoidance under the “cover” of tacrolimus, mycophenolate mofetil and extended daclizumab induction is a very effective regimen for obtaining an improvement in post–transplantation growth. The recently reported international randomized TWIST trial demonstrated growth improvement as early as 6 months post–transplantation. These protocols may potentially enable paediatric renal graft recipients to safely avoid steroid exposure.

Exclusive Author Commentary
Ryszard Grenda, 11/04/09

Steroid withdrawal is one of the most emerging medical approaches in pediatric transplantation. Risk-benefit ratio must be balanced in every individual case. Large clinical trials provide the best evidence and reliable information on efficacy and safety of minimizing protocols of immunosuppression.

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