Steroid Withdrawal in Pediatric Renal Transplant: Impact on Growth, Bone Metabolism and Acute Rejection

The intention of this investigation is to evaluate a prospective immunosuppressive protocol based on antibodies anti IL-2 (Ac-IL-2), Tacrolimus (TAC) and Mycophenolate Mofetil (MMF)and withdrawal steroids in renal transplant and to compare with a steroid-based protocol. Objectives: 1. To evaluate growth and the impairment in the GH/IGF (growth hormone/insulin like growth factor) axis 2. To determine the impact of steroids on bone metabolism (biochemical parameters, DXA and pQCT) 3. To determine the steroid effect on metabolic factors (dyslipidemia, insulin- sensitivity and arterial hypertension) 4. To determine acute rejection incidence (protocol renal biopsy) 5. To evaluate the expression of IL-17 and mRNA FoxP3 as early markers of acute rejection (blood, urine and renal biopsy). Two treatment regimes (Arms)will be compared in randomized form in the course of 12 months after transplantation. Arm A: TAC + MMF + withdrawal of steroids over a six-days following randomization. Arm B: TAC + MMF + prednisolone (see schedule)/day