Corticosteroid withdrawal in kidney transplantation: the present status

Corticosteroids (CS) have played a vital role in organ transplantation, both for prevention and treatment of allograft rejection. However, the use of CS is associated with a wide range of adverse effects. With advances in immunosuppressive drug therapy, attempts have been made to minimize the use of CS to avoid or alleviate their side effects. Withdrawal of CS months after transplantation has transitioned to days. In low to intermediate risk renal allograft recipients, use of induction therapy and modern maintenance drug combinations allows safe withdrawal of CS within the first week of transplantation. In other groups, existing potent maintenance agents permit tapering of CS to low doses over the first few months. Withdrawal of these small doses may not add to the benefits.