Reducing Steroidal Side Effects in Transplant Patients

A study has shown that simultaneous pancreas-kidney (SPK) transplant recipients who stopped steroid treatment shortly after surgery had fewer organ rejections than those who continued on an immunosuppressive regimen with long-term steroid use. The study, conducted by researchers at Northwestern University Medical School (Chicago, IL, USA), was reported at Transplant 2001 in Chicago.

Although steroids help to prevent organ rejection, they are associated with numerous side effects. These include high blood pressure, high cholesterol, increased infections, weight gain, severe loss of bone density, and damage to the immune system. The study involved 32 SPK recipients who received a two-week course of induction therapy with rabbit anti-thymocyte globulin and a short course of steroids for only six days. In the control group, 87 recipients received either horse anti-thymocyte globulin or a monoclonal anti-T cell antibody as induction therapy and continued on a permanent steroid treatment regimen. All participants received additional immunosuppressive drugs as maintenance therapy.

After six months, there was 100% functional survival of the first group versus 97% of the kidney and 95% for the pancreas in the control group (continued steroid treatment). The rejection rate after six months in the first group was only 3% compared to a rejection rate of 14% in the control group.

"With steroid-free protocols, we hope to reduce steroid-related side effects and costs for patients who require life-long immunosuppressive therapy to maintain their transplanted organs,” noted Dr. Dixon B. Kaufman, associate professor of surgery at Northwestern University Medical School.




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