Steroid pretreatment of deceased donors and liver allograft function - Ten years follow-up of a blinded randomized placebo controlled trial.Györi, G. P., et al.
International Journal of Surgery 2021; 94: 106095.
The aim of this study was to assess the effect of steroid pretreatment of deceased donors on outcomes following liver transplantation.
Donors were randomised to receive 1000 mg methylprednisone or placebo prior to organ procurement.
90 deceased liver donors.
The primary outcomes included patient survival and graft survival. The secondary outcomes were rate of biopsy proven acute rejections (BPAR) and liver functions trajectories following liver transplantation.
This paper reports the ten-year outcomes of a double-blind, randomized trial of donor pretreatment with steroids on outcomes following liver transplantation. The authors report no effect of steroid pre-treatment on patient or graft survival to 10 years post-transplant. The study was well designed, with blinding and randomization. Despite the negative results, the authors should be commended for pursuing long-term follow-up. One notable omission from the paper is the fate of the other transplanted organs from the same donors. Any study of a donor intervention should evaluate outcomes in all of the organs transplanted, not focus on just one organ type (see the systematic review from Bera et al. in this edition of Trial Watch).