Skip to main content
Log in

Successful steroid withdrawal half a year after kidney transplantation

  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

We report two kidney transplant recipients with successful steroid withdrawal. They are living related donor transplant recipients. The first patient, a 37-year-old female, received the kidney from her HLA identical father. The second patient, a 44-year-old man, received the kidney from his HLA 1 haploidentical brother. Both patients were maintained on triple immunosuppressive drug therapy pior to withdrawal of steroid and subsequently were maintained on cyclosporine and azathioprine or mizoribine. Acute rejection occurred within the first 1 month and was treated with steroid bolus therapy successfully in both cases. The time of steroid withdrawal after transplantation was 6.5 months in the first patient and 5 months in the second patient. After steroid withdrawal their graft function remained stable and the graft specimens obtained by biopsy 8 months after withdrawal showed no signs of rejection; no side effects of steroid appeared. These results suggest that steroid withdrawal half a year after transplantation can be accomplished without jeopardizing graft function in selected living related donor transplant recipients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Walker, R. G., d'Apice, A. J. F.: Azathioprine and steroids. In: Morris, P. J. (ed.): Kidney Transplantation. Third Edition, W. B. Saunders Company, Harcourt Brace Jovanovich, Inc., Philadelphia 1988, pp. 319–341.

    Google Scholar 

  2. Rosenthal, J. T., Hakala, T. R., Iwatsuki, S., Shaw, B. W., Starzl, T. E.: Cadaveric renal transplantation under cyclosprine-steroid therapy.Surg. Gynecol. Obstet., 157, 309 (1983).

    PubMed  CAS  Google Scholar 

  3. Hricki, D. E., Schulak, J. A.: Metabolic effects of steroid withdrawal in adult renal transplant recipients.Kidney Int., 44 (Suppl. 43), S26 (1993).

    Google Scholar 

  4. Grushkin, C. M., Fine, R. N.: Growth in children following renal transplantation.Am. J. Dis. Child., 125, 514 (1973).

    PubMed  CAS  Google Scholar 

  5. Hricik, D. E., Bartucci, M. R., Mayes, J. T., Schulak, J. A.: Effects of steroid withdrawal on lipoprotein profiles of cyclosporine treated kidney and kidney-pancreas transplant recipients.Transplantation, 54, 868 (1992).

    Article  PubMed  CAS  Google Scholar 

  6. Propovtzer, M. M., Pinnggera Katz, F. H.: Variations in arterial blood pressure after kidney transplantation: Relation to renal function, plasma renin activity, and the dose of prednisone.Circulation, 47, 1297 (1973).

    Google Scholar 

  7. Ruiz, J. O., Simmons, R. L., Callender, C. O., Kjellstrand, C. M., Buselmeier, T. J., Najarian, J. S.: Steroid-induced diabetes in renal transplant patients: Pathogenic factors and prognosis.Surgery, 73, 759 (1973).

    PubMed  CAS  Google Scholar 

  8. Schulak, J. A., Hricik, D. E.: Steroid withdrawal after renal transplantation.Clin. Transplantation, 8, 211 (1994).

    CAS  Google Scholar 

  9. Reisman, L., Lieberman, K. V., Burrows L., Schanzer, H.: Follow-up of cyclosporine treated pediatric renal allograft recipients after cessation of prednisone.Transplantation, 49, 76 (1990).

    Article  PubMed  CAS  Google Scholar 

  10. Calne, R. Y.. Cyclosporin in cadaveric renal transplantation: 5-year follow up of a multicentre trial.Lancet, 2, 506 (1987).

    Article  PubMed  CAS  Google Scholar 

  11. Hariharan, S., Schroeder, T. J., Weiskittle, P., Alexander, J. W., First, M. R.: Prednisone withdrawal in HLA identical and one haplotype-matched live-related donor and cadaver renal transplant recipients.Kidney Int., 44 (Suppl. 43), S30 (1993).

    Google Scholar 

  12. Stratta, R. J., Armbrust, M. J., Oh, C. S., Pirsch, J. D., Kalayoglu, M., Sollinger, H. W., Belzer, F. O.: Withdrawal of steroid immunosuppression in renal transplant recipients.Transplantation, 45, 323 (1988).

    Article  PubMed  CAS  Google Scholar 

  13. Mendez, R., Aswad, S., Mendes, R. G., Cicciarelli, J., Asai, P., Sakhrani, L., Bogaard, T., Khetan, U., Flores, N.: Steroid withdrawal in HLA-nonidentical living-related donor transplant recipients.Transplant. Proc., 24, 1891 (1992).

    PubMed  CAS  Google Scholar 

  14. Schulak, J. A., Mayes, J. T., Moritz, C. E., Hricik, D. E.: A prospective randomized trial of prednisone versus no prednisone maintenance therapy in cyclosporine-treated and azathioprine-treated renal transplant recipients.Transplantation, 49, 327 (1990).

    Article  PubMed  CAS  Google Scholar 

  15. Hricik, D. E., Whalen, C. C., Lautman, J., Bartucci, M. R., Moir, E. J., Mayes, J. T., Schulak, J. A.: Withdrawal of steroids after renal transplantation. Clinical predictors of outcome.Transplantation, 53, 41 (1992).

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yagisawa, T., Nakada, T., Hiromasa, Y. et al. Successful steroid withdrawal half a year after kidney transplantation. International Urology and Nephrology 27, 495–501 (1995). https://doi.org/10.1007/BF02550089

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02550089

Keywords

Navigation