Rapid discontinuation of the immunosuppressive steroid prednisone after a kidney transplant can help prevent serious side-effects, according to a study published in the Clinical Journal of the American Society Nephrology (CJASN).
Arthur Matas (University of Minnesota, Minneapolis) and colleagues conducted a long term, 10-year study that followed 1,241 kidney transplant recipients on a treatment regimen that included rapid discontinuation of prednisone (within five days of transplantation).
The study included 791 patients who received kidneys from live donors and 450 who received kidneys from deceased donors.
Among the major findings after 10 years:
- 71% of patients who received kidneys from living donors and 62% of those who received kidneys from deceased donors survived.
- 61% of kidneys from living donors and 51% of kidneys from deceased donors survived.
- Early organ rejection rates were 25% and 31% for deceased and living donor kidneys respectively.
- Chronic organ rejection rates were 39% and 47% for deceased and living donor kidneys respectively.
- The incidence rates of new-onset diabetes and several other complications were significantly lower than rates typically seen in transplant patients on prednisone.
These findings indicate that the long-term patient and kidney survival rates are similar for transplant recipients who quickly stop taking prednisone and recipients who continue to take it (based on national averages).
“Because prednisone use is associated with numerous side-effects, transplant recipients say it is the drug they would most like to avoid,” said Dr Matas.
“Our data suggest that long-term prednisone may not be necessary after a kidney transplant.”