Survival Better For Kidney Recipients Taken Off Steroids

May 09, 1997

Weaning kidney transplant recipients off steroids is associated with excellent patient and graft survival, according to results of a study being presented at the ASTP meeting May 11 by Ron Shapiro, M.D., associate professor of surgery at the University of Pittsburgh's Thomas E. Starzl Transplantation Institute. In addition, the study of patients whose immunosuppression was managed with the anti-rejection drug tacrolimus, or Prograf, found the incidence of rejection was much lower in patients who no longer took steroids.

Surgeons routinely prescribe steroids, such as prednisone, in combination with other drugs to help protect a transplanted kidney from being rejected. However, steroids can cause side-effects ranging from weight gain, puffy cheeks and unwanted facial hair to more serious medical complications, such as muscle wasting, diabetes, osteoporosis and susceptibility to infections.

In Dr. Shapiro's study, 289 out of 379 adult kidney patients were taken off prednisone between four and 36 months after receiving transplants from cadaveric or living-related donors. One-year patient survival was 99 percent in the group no longer taking steroids, compared to 91 percent of those still on steroids. At three years, patient survival was 98 and 80 percent, respectively. One- and three-year graft survival was 98 and 94 percent in the patients taken off steroids, compared to 77 and 50 percent in the patients not weaned, in whom there was also a higher incidence of rejection (73 percent). Rejection occurred in 43 percent of those taken off steroids.

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University of Pittsburgh Medical Center

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