To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Steroid Avoidance Safe for Most Kidney Transplant Recipients, but Clinicians Should Be Vigilant for Early Signs of Rejection: Presented at ATC URL: http://www.pslgroup.com/dg/223202.htm Doctor's Guide June 6, 2008
By Thomas S. May TORONTO -- June 6, 2008 -- The popular steroid-avoidance regimen provides benefits to the majority of renal transplant recipients, but clinicians should initiate maintenance steroid treatment in patients showing signs of rejection. Richard Baker, MD, Renal Unit, St. James University Hospital, Leeds, United Kingdom, and colleagues analysed data on kidney transplant recipients treated with a steroid avoidance (January 2004 to October 2006) and a control group who received kidney transplants before the introduction of the steroid-avoidance regimen (2001 through 2003). The study enrolled 258 low- to medium-risk adult patients who received kidney transplants treated with steroid avoidance and 216 patients who were not treated with steroid avoidance. The study results were presented in a poster session on June 3 at the 2008 American Transplant Congress (ATC). Baseline demographics were similar in the 2 groups except for higher proportions of "donation-after cardiac-death" (DCD) and living donors in the later cohort. The researchers found that the rate of acute rejection was significantly higher in the steroid-avoidance group (19.8% vs 12.5%, P = .045). Furthermore, in those patients who experienced a rejection episode, the 1-year graft survival was significantly lower in the steroid avoidance group than in the control patients (80.3% vs 100% respectively, P = .045). All the patients who remained on steroids after a rejection episode had a preserved graft at 1 year compared with 27.7% of the 36 patients who did not start steroid therapy after a rejection episode. Based on these findings, Dr. Baker suggested that transplant physicians using steroid avoidance in their patients should look for early signs of rejection and reintroduce steroids if they notice any such signs. "Any clinician looking after transplant patients who have steroid avoidance should be very vigilant for signs of rejection, and once detected, we would advocate continuing oral steroid treatment for at least 6 months," he said. "The question to address in the future is whether steroid-avoidance patients should undergo protocol biopsies to look for early subclinical rejection, and whether this deterioration in function can be rectified by continuing oral steroid therapy," Dr. Baker added. [Presentation title: Steroid Avoidance Good for Most but Is There a Price to Pay? Abstract 1545] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.