ADVANTAGES OF LOW DOSE STEROID FROM THE DAY AFTER RENAL TRANSPLANTATION

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Abstract
A low dose of steroid (20 mg of prednisolone) commencing the day after transplantation was used for 151 consecutive renal transplants in 141 patients. Five patients received grafts from living related donors and 146 received cadaver grafts. All patients received azathioprine for routine immunosuppression and the first 47 received a single dose of actinomycin C i.v. for treatment of rejection. No other immunosuppressive drugs were used. This treatment provided satisfactory immunosuppression as 109 of 151 grafts continue to function for periods of 3 mo. to 10 yr, and of 42 grafts lost, only 17 failed from rejection. The cumulative survival of first cadaver grafts at 1 and 2 yr in recipients of all ages (7-55 yr) was 77.9 and 76.0%, respectively; in recipients 15-34 yr old, 90.9 and 86.1%, respectively. Twenty-three patients died; no patient died from infection during the admission for transplantation, and infection played a part in the deaths of only 4 patients. The incidence of other complications was low; 7 patients developed gastrointestinal complications and 1 died; 4 patients developed diabetes and all survived; only 1 patient developed avascular necrosis of bone.