Project 6

Steroid Sparing

The morbidity related to long-term steroid therapy has led to interest in withdrawal of steroids from immunosuppressant regimens following transplantation, particularly with the introduction of newer, more potent maintenance immunosuppression and induction agents. Previous systematic reviews have examined small subsets of renal transplant patients only, and a number of recent trials provide greater longer term information regarding the effects of steroid withdrawal. This review aims to be the most comprehensive and up-to-date yet, providing information regarding outcomes not previously reported and patients receiving transplants other than kidneys.

The full analysis of this review has been presented by Simon Knight at the International Transplant Society congress in Sydney Australia and at the BTS meeting in April, 2009, where it won the Medawar Prize. The full paper and meta analysis has been published in Transplantation in January,2010.

Knight SR, Morris PJ. Steroid avoidance or withdrawal following renal transplantation increases the risk of acute rejection but decreases cardiovascular risk. A meta-analysis. Transplantation 2010. Jan 15; 89 (1): 1-14