Evidence map›Paper›PMID 41134310›Full record

ArticleClinical transplantation2025

Steroid Withdrawal Versus Maintenance in Simultaneous Pancreas-Kidney Transplantation: Long-Term Outcomes in a Single-Center Retrospective Cohort.

Raphael P H Meier, Ali B Abbasi, Gerardo Gamino, Yvonne M Kelly, Mehdi Tavakol, Giulia Conti, Minnie Sarwal, Peter G Stock, Chris E Freise

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Raphael P H MeierDivision of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0001-9050-0436
Ali B AbbasiDivision of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-1039-2832
Gerardo GaminoDivision of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, California, USA.
Yvonne M KellyDivision of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, California, USA.
Mehdi TavakolDivision of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, California, USA.
Giulia ContiDivision of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, California, USA.
Minnie SarwalDivision of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, California, USA.
Peter G StockDivision of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, California, USA.
Chris E FreiseDivision of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, California, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSimultaneous pancreas and kidney (SPK) transplants using steroid-free regimens are a frequently used immunosuppressive strategy in low immunologic risk recipients. The long-term effect on recipient outcomes remains incompletely understood.

methodsWe analyzed post-transplant outcomes in 307 SPK recipients from a single center, comparing early steroid withdrawal (after completion of Thymoglobulin) with maintenance steroids. Steroid withdrawal was primarily utilized in low immunologic risk patients.

resultsIn total, 170 SPK recipients underwent steroid withdrawal, and 137 received maintenance steroids. The withdrawal group had a lower cPRA and included fewer Black recipients. Biopsy-proven rejection rates (kidney, pancreas, or both) were similar between groups (26% vs. 29%, p = 0.523), with worse kidney/pancreas graft survival among those with rejection. Rejection occurred earliest in recipients rejecting both the kidney and pancreas, followed by those rejecting the kidney alone, and then those rejecting the pancreas. Multivariate analysis showed that kidney and pancreas survival were strongly interdependent. Kidney rejection was the primary predictor of graft survival. The steroid regimen was not independently associated with survival of either organ. Obesity at follow-up was associated with an increased risk of pancreas graft failure.

conclusionIn this single-center cohort, steroid withdrawal was safe in appropriately selected SPK recipients, with rejection-not the steroid regimen-driving long-term graft outcomes.

Indexed as

Graft RejectionImmunosuppressive AgentsKidney TransplantationPancreas TransplantationPostoperative ComplicationsSteroidsAdultFemaleFollow-Up StudiesGraft SurvivalHumansKidney Function TestsMaleMiddle AgedPrognosisRetrospective StudiesImmunosuppressive AgentsSteroidsbody mass indexdiabetesend‐stage renal diseaseimmunosuppressionoutcomessimultaneous pancreas and kidney transplantationsteroids

Identifiers

PMID41134310
PMCPMC12551689

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.