Steroid-free immunosuppression in organ transplantation.
Although steroids have been the cornerstone of immunosuppressive regimens to treat and prevent rejection in organ transplantation, the past decade has seen many successful attempts to minimize or eliminate steroid use. This has been undertaken to decrease the diverse side effects seen with chronic steroid treatment. These efforts have focused on both steroid avoidance and complete elimination, and have been successful across broad patient groups. The key to these efforts has been the adoption of induction protocols with either lymphocyte-depleting agents or anti-interleukin-2 strategies, coupled with the use of the newer maintenance immunosuppressants. In this review, we address the feasibility and benefits of steroid-free and steroid avoidance protocols in kidney, pancreas, liver, and heart transplantation.
Luo
Gaoxing
G
Radiation and Combat Injury Department/Code 33, Combat Casualty Care Directorate, Naval Medical Research Center, Silver Spring, MD 20910-6500, USA.
Falta
Edward M
EM
Elster
Eric A
EA
D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival / Q000276:immunology; D016027:Heart Transplantation / Q000276:immunology / Q000379:methods; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology / Q000379:methods; D016031:Liver Transplantation / Q000276:immunology / Q000379:methods; D016377:Organ Transplantation / Q000379:methods*; D016035:Pancreas Transplantation / Q000276:immunology / Q000379:methods; D013256:Steroids / Q000009:adverse effects / Q000276:immunology; D014181:Transplantation Immunology
D007166:Immunosuppressive Agents; D013256:Steroids