Effects of steroids in combination with other pharmacologic immunosuppressive agents

Steroids are commonly employed as immunosuppressive agents following organ transplantation. They may be given in large doses at the time of transplantation and also at times of rejection. At lower doses they are commonly used as maintenance therapy. The justification for these forms of treatments has been critically examined, and the author refers to his own experimental studies and clinical trials of steroids following kidney transplantation. The conclusion reached is that steroids are usually effective in reversing rejection, but there is no good evidence that they are required at the moment of transplantation or for long-term administration afterward if patients are already receiving cyclosporine.