Aref, Ahmed, Sharma, Ajay and Halawa, Ahmed 
ORCID: 0000-0002-7305-446X
(2021)
Does steroid-free immunosuppression improve the outcome in kidney transplant recipients compared to conventional protocols?
World journal of transplantation, 11 (4).
pp. 99-113.
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Abstract
Steroids continue to be the cornerstone of immune suppression since the early days of organ transplantation. Steroids are key component of induction protocols, maintenance therapy and in the treatment of various forms of rejection. Prolonged steroid use resulted in significant side effects on almost all the body organs owing to the presence of steroid receptors in most of the mammalian cells. Kidney allograft recipients had to accept the short and long term complications of steroids because of lack of effective alternatives. This situation changed with the intro-duction of newer and more effective immune suppression agents with a relatively more acceptable side effect profile. As a result, the clinicians have been contemplating if it is the time to abandon the unquestionable reliance on maintenance steroids in modern transplantation practice. This review aims to evaluate the safety and efficacy of various steroid-minimization approaches (steroid avoidance, early steroid withdrawal, and late steroid withdrawal) in kidney transplant recipients. A meticulous electronic search was conducted through the available data resources like SCOPUS, MEDLINE, and Liverpool University library e-resources. Relevant articles obtained through our search were included. A total number of 90 articles were eligible to be included in this review [34 randomised controlled trials (RCT) and 56 articles of other research modalities]. All articles were evaluating the safety and efficacy of various steroid-free approaches in comparison to maintenance steroids. We will cover only the RCT articles in this review. If used in right clinical context, steroid-free protocols proved to be comparable to steroid-based maintenance therapy. The appropriate approach should be tailored individually according to each recipient immuno-logical challenges and clinical condition.
| Item Type: | Article |
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| Uncontrolled Keywords: | Immune suppression, Kidney transplantation, Outcome, Steroid avoidance, Steroid free, Steroid withdrawal |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences > School of Medicine |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 08 Nov 2022 10:56 |
| Last Modified: | 15 Mar 2024 11:49 |
| DOI: | 10.5500/wjt.v11.i4.99 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3166045 |
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