title: A short course of methylprednisolone immunosuppression inhibits both rejection and spontaneous acceptance of rat liver allografts.
abstract: BACKGROUND
  The effects of immunosuppressive drugs on transplant tolerance have not been extensively studied, although their effect on rejection is well established.
  
  
  METHODS
  We examined the effects of a short course of treatment with the immunosuppressive drug methylprednisolone (MP) on the survival of PVG liver allografts in Dark Agouti (DA) recipients that accepted the livers and in Lewis recipients that rejected the livers. Infiltration of liver allografts was examined by immunohistochemical staining of liver sections, and apoptosis was measured by terminal deoxynucleotide transferase-mediated dUTP nick end labeling.
  
  
  RESULTS
  A 5-day course of MP (days 0 to 4) led to rejection of four of six livers (mean survival time [MST] 99 days) in DA recipients compared with long-term survival (MST >100 days) in untreated animals. Delayed administration of MP (days 3 to 7) exacerbated rejection in DA recipients, and all eight animals rejected the graft (MST 68.5 days). Treatment of Lewis recipients with MP did not significantly prolong survival when administered from days 0 to 4 (MST 13 days), although delay of administration improved the outcome. Treatment from days 3 to 7 resulted in an MST of 21 days, whereas treatment from days 7 to 11 resulted in an MST of 41.5 days. MP treatment from day 3 to day 7 reduced T cells and interleukin 2 receptor-expressing cells but increased the numbers of apoptotic cells infiltrating both DA and Lewis strain allografts.
  
  
  CONCLUSIONS
  These results show that immunosuppression with MP inhibits both spontaneous tolerance and rejection of liver allografts in a rat model and question the efficacy of administering MP to all liver allograft recipients from the time of transplantation.
authors.affiliation: Royal Prince Alfred Hospital, Department of Transplantation, The University of Sydney, New South Wales, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Wang
authors.forename: J
authors.initials: J
authors.lastname: Sun
authors.forename: A G
authors.initials: AG
authors.lastname: Sheil
authors.forename: G W
authors.initials: GW
authors.lastname: McCaughan
authors.forename: G A
authors.initials: GA
authors.lastname: Bishop
mesh_terms: D000818:Animals; D017209:Apoptosis; D002465:Cell Movement; D004334:Drug Administration Schedule; D006084:Graft Rejection / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects*; D007150:Immunohistochemistry; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007962:Leukocytes / Q000473:pathology / Q000502:physiology; D008099:Liver / Q000378:metabolism / Q000473:pathology; D016031:Liver Transplantation; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D051381:Rats; D011917:Rats, Inbred Lew; D011919:Rats, Inbred Strains; D013154:Spleen / Q000473:pathology; D014019:Tissue Donors; D023001:Transplantation Tolerance / Q000187:drug effects; D014184:Transplantation, Homologous
chemical_list: D007166:Immunosuppressive Agents; D008775:Methylprednisolone