[Evaluation of efficacy and safety on steroid withdraw at the seventh day after liver transplantation].
OBJECTIVE
To evaluate efficacy and safety on steroid withdrawal at the seventh day after liver transplantation.


METHODS
Seventy-six adult patients undergoing first cadaveric liver transplantation from October 2005 to October 2007 were randomly divided into 7 day (n = 40) and 3 month (n = 36) steroid withdrawal groups. All patients received FK506 3 mg and intravenous methylprednisolone 1000 mg during intra-operation and FK506 thereafter was adjusted to predefined 8 - 12 microg/L from day 1 to month 6. Patients in 7 day steroid withdrawal group received 500, 240, 200, 160, 80, 40 and 20 mg intravenous methylprednisolone tapered daily from postoperative day 1 to day 7. In 3 month steroid withdrawal group, patients received the same protocol as 7 day steroid withdrawal group for intravenous methylprednisolone tapered daily from postoperative day 1 to day 7 and thereafter received oral prednisone 48, 40, 32, 24, 16, 8, 4 mg tapered every 3 days and maintained 4 mg to the 3(rd) month. All patients were followed up for 6 months. The incidence of treated acute rejection and side effects were evaluated between two groups.


RESULTS
A total of 69 cases were fully followed up, and 7 cases were discontinued including death (n = 2), server infection (n = 2), protocol violation (n = 2) and retransplantation (n = 1). There were no statistical difference between 2 groups concerning the incidence of acute rejection, hypertension, hyperlipemia and other adverse events (P > 0.05), but significant difference in incidence of diabetes (17.5% vs. 38.9%, P = 0.047).


CONCLUSIONS
Steroid withdrawal strategy at day 7 is same safety and efficacy as steroid withdrawal at 3 month.
Hu
An-bin
AB
Organ Transplantation Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
He
Xiao-shun
XS
Wu
Zhi-peng
ZP
Zhu
Xiao-feng
XF
Ma
Yi
Y
Wang
Dong-ping
DP
Wang
Guo-dong
GD
Tai
Qiang
Q
Ju
Wei-qiang
WQ
Wu
Lin-wei
LW
Huang
Jie-fu
JF
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; 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; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D011182:Postoperative Care; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016559:Tacrolimus; D008775:Methylprednisolone