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Long-term immunosuppression after liver transplantation: are steroids necessary?
Authors:R.T.A. Padbury  B.K. Gunson  B. Dousset  S.G. Hubscher  A.D. Mayer  J.A.C. Buckels  J.M. Neuberger  E. Elias  P. McMaster
Abstract:Steroid therapy was withdrawn in 85% of 152 orthotopic liver transplant recipients with grafts surviving for more than 3 months, and 87% of these remained steroid-free. Steroid therapy was restarted in 8% for reasons other than rejection. The most common was conversion of immunosuppression because of cyclosporine nephrotoxicity. The incidence of rejection after steroid withdrawal was low: 3.8% for chronic rejection (CR) and 4.5% for acute rejection. Only 3 grafts (1.9%) were lost because of CR. No risk factors have been identified for the development of CR after steroid withdrawal, but a protective role for azathioprine has been suggested.
Keywords:Immunosuppression  Steroids  Liver transplantation
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