Corticosteroid elimination in simultaneous liver-kidney transplantation recipients.
BACKGROUND
Simultaneous liver-kidney transplantation (SLK) has more than doubled since 2002. While less common in kidney transplant alone recipients (KTA), corticosteroid discontinuation is performed routinely in liver transplantation, raising the question of optimal immunosuppression for SLK recipients.


METHODS
A retrospective case series of 16 SLK recipients under a steroid withdrawal protocol was performed to compare short-term outcomes to a contemporaneous cohort of 32 KTA recipients.


RESULTS
In 69% of SLK recipients, corticosteroids were eliminated compared to 3% of KTA recipients, p < 0.0001. When comparing SLK and KTA recipients one yr post-transplant, there were no significant differences in renal graft rejection (23.1% vs. 6.3%), death-censored renal graft survival (100% vs. 97%), estimated glomerular filtration rate (74.4 vs. 62.6 mL/min), serum creatinine (1.10 vs. 1.39 mg/dL), or maintenance immunosuppression, respectively.


CONCLUSIONS
Corticosteroids may be withdrawn safely in SLK recipients with one-yr renal outcomes comparable to a KTA cohort.
Weber
Nicholas K
NK
Division of Gastroenterology and Hepatology, University of Colorado Health Sciences Center, Aurora, CO, USA.
Wiseman
Alexander C
AC
Trotter
James F
JF
D000208:Acute Disease; D019703:Calcineurin / Q000097:blood; D065095:Calcineurin Inhibitors; D000075202:Contraindications; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids; D006084:Graft Rejection / Q000175:diagnosis / Q000201:enzymology / Q000517:prevention & control*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D017093:Liver Failure / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
D065095:Calcineurin Inhibitors; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D019703:Calcineurin