Corticosteroids in organ transplantation

This chapter presents an organ-by-organ review of immunosuppression use, especially focuses on corticosteroids use. In response to concerns about the adverse effects associated with steroid-based regimen increases, many transplant recipients are being taken off corticosteroids as a maintenance therapy or not being given it in the first place. Corticosteroids were still administered to the majority of patients, though regimens of steroid avoidance and steroid withdrawal have been increasing in use. As the number of available choices expands, the mosaic of the practice of immunosuppression in transplantation becomes more textured. This chapter reviews and describes a number of these trends, including the increased application of corticosteroid avoidance and withdrawal, the evolution towards tacrolimus-centered immunosuppression, and the emerging use of basiliximab.