In vitro sensitivity to prednisolone may predict kidney rejection after steroid withdrawal

Transplantation
G J BoumaF H Claas

Abstract

A maintenance immunosuppressive regimen of cyclosporine and steroids after renal transplantation has proven to be a successful policy to obtain long-term graft survival. However, serious side-effects are associated with this therapy; these include an increased risk for infections, cancer, and cardiovascular morbidity and mortality. Therefore, this pilot study was conducted to investigate the possibility of reducing the immunosuppressive load after transplantation. To this end, we tried to develop an in vitro assay to predict graft rejection after withdrawing steroids from the immunosuppressive therapy. Patients who had stable renal function at least one year after transplantation were randomly divided into a group that continued to receive standard immunosuppression of cyclosporine and steroids and a group to be withdrawn from steroid therapy, the latter group being the subject of the present study. Patients withdrawn from steroids were monitored closely and when a biopsy-proven rejection occurred, steroid treatment was reestablished. Blood was collected from patients preceding steroid withdrawal and at fixed time points thereafter. In case of suspected rejection, blood was also taken before biopsy, before steroid treatment was...Continue Reading

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Citations

May 15, 2003·Journal of Interferon & Cytokine Research : the Official Journal of the International Society for Interferon and Cytokine Research·Christoph HärtelMichael Müller-Steinhardt
Oct 4, 2011·Biological & Pharmaceutical Bulletin·Hironori TakeuchiTakeshi Nagao
Dec 13, 2006·International Immunopharmacology·Toshihiko Hirano
Aug 23, 2016·The Cochrane Database of Systematic Reviews·Maria C HallerAngela C Webster

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