Early promise for steroid-free liver transplantation in children

December 18, 2003

Results of a preliminary study into paediatric liver transplantation in this week's issue of THE LANCET suggest that successful transplantation could take place without the need for steroid treatment-with potential health benefits for transplant recipients.

Steroids have been central to immunosuppressive therapy since the early days of transplantation; however, steroid avoidance could be beneficial, especially among children as steroids are often associated with negative outcomes including arterial hypertension, growth retardation, and hyperlipidemia.

In a pilot study, Raymond Reding and colleagues from Saint-Luc University, Brussels, Belgium, compared the success of liver transplantation under steroid-free immunosuppression in 20 children with a group of 20 historical controls (children who had been previously given steroids for liver transplantation). Children not given steroids had reduced rates of graft rejection (25%) after 12 months compared with children who had been given steroid treatment (50%).

Raymond Reding comments: "Except for one preliminary report, findings on steroid-free immunosuppression have yet to be reported for paediatric liver transplantation. Our results suggest no harmful effect of steroid avoidance for graft acceptance, but this finding will need to be confirmed after extended follow-up."
Lancet 2003; 362: 2068-2070

Professor Raymond Reding,
Paediatric Surgical Unit (1401),
Saint-Luc University Clinics,
10 Hippocrate Avenue,
B-1200 Brussels, Belgium;
T) 32-2-764-1401;
F) 32-2-764-8954;
E) reding@chex.ucl.ac.be


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