Steroid avoidance in liver transplantation.
Corticosteroids have always played a valuable role in transplantation. Unfortunately, they are subject to a wide range of side effects, such as hyperlipidemia, hypertension, diabetes mellitus, osteoporosis, growth retardation and Cushingoid appearance. Steroids may also exacerbate problems that existed before surgery, including malignancy, hepatitis B and hepatitis C. New, powerful immunosuppressants have allowed steroid use to be reduced or avoided altogether, but use of these regimens is not simple and may be associated with late acute rejection and recurrence of autoimmune disease. The present review examines the rationale for steroid avoidance in liver transplantation and assesses the new regimens that are currently being developed.
Oberholzer
José
J
Hepatobiliary and Pancreatic Surgery, University of Alberta, Edmonton, Alberta, Canada.
Al-Saghier
Mohammed
M
Kneteman
Norman M
NM
D000818:Animals; D015195:Drug Design; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016031:Liver Transplantation / Q000379:methods*
D005938:Glucocorticoids; D007166:Immunosuppressive Agents