Successful steroid withdrawal after long-term administration in renal transplant patients.
OBJECTIVE
This study evaluated the effect of steroid withdrawal after long-term administration on stably functioning renal transplant recipients.


METHODS
Between April 2000 and October 2006, steroid administration was safely withdrawn in 47 patients with stable graft function for >1 year after renal transplantation. The period between renal transplantation and steroid withdrawal varied from 12 to 234 months. We also investigated the current steroid doses of all 274 outpatients who had undergone renal transplantation at our hospital between July 1977 and October 2006.


RESULTS
Twelve patients out of 47 had to resume steroid administration, 10 (21%) owing to acute rejection with/without recurrent glomerulonephritis, 1 owing to treatment of subacute thyroiditis, and the other owing to accompanying cessation of azathioprine for ovarian cancer. Thirty-five patients have maintained stable graft function for 12 to 90 months (median, 49) after steroid withdrawal as confirmed by follow-up. At present, only 1 of the 47 patients had to resume hemodialysis owing to chronic deterioration of renal graft function. The current steroid doses (prednisolone equivalent) of the 274 outpatients at our hospital are as follows: The number of patients for withdrawn, <5 mg, 5 mg, >5 to 10 mg, and >10 mg/d is 38, 20, 155, 57, and 4, respectively. Of 294 patients, 213 (77.7%) are maintaining stable renal graft functions on </=5 mg prednisolone per day.


CONCLUSIONS
Steroids can be safely withdrawn in renal transplant patients with stable graft functions, even after long-term administration.
Amada
N
N
Department of Surgery, Sendai Shakaihoken Hospital, Sendai, Japan. amada-n@umin.ac.jp
Kikuchi
H
H
Haga
I
I
Fukumori
T
T
Sato
A
A
Sato
T
T
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D002102:Cadaver; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000188:drug therapy; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology / Q000502:physiology*; D019520:Living Donors; D008297:Male; D009679:Nuclear Family; D010045:Outpatients; D010051:Ovarian Neoplasms / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D006435:Renal Dialysis; D012189:Retrospective Studies; D012449:Safety; D013997:Time Factors; D014019:Tissue Donors
D000305:Adrenal Cortex Hormones; D011239:Prednisolone