TY - JOUR
T1 - Steroid withdrawal in adult liver transplantation
T2 - Occurrence at a single center
AU - Kim, J. M.
AU - Joh, J. W.
AU - Kim, S. J.
AU - Kwon, C. H.D.
AU - Song, S.
AU - Shin, M.
AU - Hong, S. H.
AU - Lee, S. K.
PY - 2010/12
Y1 - 2010/12
N2 - Backgrounds Steroids are the predominant immunosuppressive agent used after liver transplantation even though patients may experience steroid-related side effects. Aims The objective of this study was to determine whether steroid use influenced the outcomes of liver transplantations. Methods Three hundred forty-four adult patients underwent liver transplantation between May 2002 and December 2007. We reviewed the medical records of these patients, excluding those younger than 18 years old or those who died within the first month. The protocol withdrawal group (group 1) ceased steroid use within 5 months after transplantation, while the late withdrawal group (group 2) continued steroid use beyond this 5-month posttransplantation period. Results All patients were classified according to the onset of steroid withdrawal (group 1: n = 243; group 2: n = 99). The incidences of biopsy-confirmed and treated acute rejection episodes (ARE) at 12 and 24 months posttransplantation were 7.8% and 12.3% in group 1, but 25.3% and 27.3% in group 2, respectively (P = .001). The incidence of hepatitis B virus (HBV) recurrence in group 2 was higher than that in group 1 (P = .007). The HBV-free survival rates at 1 and 2 years posttransplantation were 99.0% and 97.1% in group 1 and 96.1% and 92.1% in group 2, respectively. New-onset diabetes, avascular necrosis of the femoral head, corticosteroid- resistant ARE, hepatocellular carcinoma recurrence, as well as graft and patient survivals did not differ between the two groups. Conclusions Acute rejection episodes and HBV recurrence occurred less frequently when steroids were discontinued within 5 months after liver transplantation.
AB - Backgrounds Steroids are the predominant immunosuppressive agent used after liver transplantation even though patients may experience steroid-related side effects. Aims The objective of this study was to determine whether steroid use influenced the outcomes of liver transplantations. Methods Three hundred forty-four adult patients underwent liver transplantation between May 2002 and December 2007. We reviewed the medical records of these patients, excluding those younger than 18 years old or those who died within the first month. The protocol withdrawal group (group 1) ceased steroid use within 5 months after transplantation, while the late withdrawal group (group 2) continued steroid use beyond this 5-month posttransplantation period. Results All patients were classified according to the onset of steroid withdrawal (group 1: n = 243; group 2: n = 99). The incidences of biopsy-confirmed and treated acute rejection episodes (ARE) at 12 and 24 months posttransplantation were 7.8% and 12.3% in group 1, but 25.3% and 27.3% in group 2, respectively (P = .001). The incidence of hepatitis B virus (HBV) recurrence in group 2 was higher than that in group 1 (P = .007). The HBV-free survival rates at 1 and 2 years posttransplantation were 99.0% and 97.1% in group 1 and 96.1% and 92.1% in group 2, respectively. New-onset diabetes, avascular necrosis of the femoral head, corticosteroid- resistant ARE, hepatocellular carcinoma recurrence, as well as graft and patient survivals did not differ between the two groups. Conclusions Acute rejection episodes and HBV recurrence occurred less frequently when steroids were discontinued within 5 months after liver transplantation.
UR - https://www.scopus.com/pages/publications/78650440693
U2 - 10.1016/j.transproceed.2010.10.018
DO - 10.1016/j.transproceed.2010.10.018
M3 - Article
C2 - 21168644
AN - SCOPUS:78650440693
SN - 0041-1345
VL - 42
SP - 4132
EP - 4136
JO - Transplantation Proceedings
JF - Transplantation Proceedings
IS - 10
ER -
