Steroid withdrawal five days after renal transplantation allows for the prevention of wound‐healing complications associated with sirolimus therapy

Abstract

Early steroid withdrawal is effective in preventing both the incidence and the severity of wound-healing complications because of SRL regime, even when started with a loading dose.

Early (fifth day) vs. late (sixth month) steroid withdrawal in renal transplant recipients treated with Neoral® plus Rapamune®: four‐yr results of a randomized monocenter study

“…The hypothesis is that delaying steroid suspension to month three or six after transplantation might allow the selection of patients with risk factors for acute rejection (6,7). Moreover, in our experience, early steroid suspension reduces significantly the incidence of post-surgical wound complications often observed in patients on Sirolimus-based regimen (10). However, early steroid withdrawal could also be advantageous as it prevents all steroid side effects arising soon after transplantation (8,9).…”

Sirolimus vs mycophenolate mofetil (MMF) in primary combined pancreas and kidney transplantation. Results of a long-term prospective randomized study

“…In comparison with registry data, this represents quite a low number . However, it did not unnecessarily increase the rejection rate, as reported by other authors, and may even have prevented some of the undesirable metabolic effects attributed to sirolimus therapy …”

“…21 However, it did not unnecessarily increase the rejection rate, as reported by other authors, 22 and may even have prevented some of the undesirable metabolic effects attributed to sirolimus therapy. 17,23 Throughout the study, tacrolimus and sirolimus dose were quite stable with trough levels, usually not exceeding 10 ng/mL.…”

Prophylactic Peritoneal Fenestration to Prevent Morbidity After Kidney Transplantation: A Randomized Study

“…After autotransplantation, the occurrence of lymphoceles is rare, indicating that concomitant use of immunosuppression is an important pathogenetic factor (8). High steroid load is a risk factor for development of lymphoceles (11), and early withdrawal of steroids after kidney transplantation has resulted in a significantly lower incidence (12). On the other hand, we did not routinely use mammalian target of rapamycin inhibitors, which is associated with a higher frequency of lymphoceles compared with other immunosuppressive regimens (13)(14)(15).…”