Successful immunosuppression of renal allograft recipients with alternate day steroid therapy

Twenty-five renal transplant recipients have been treated long-term with immunosuppressive therapy with conversion from a daily dose to an every other day dose of steroids in conjunction with daily administration of Imuran. The patients were selected by having stable grafts for 6 to 9 months prior to conversion, not by the presence of steroid-induced complications. Alternate day steroid administration has continued to provide successful immunosuppression in that only of 25 patients (4%) has had any evidence of renewed rejection activity during a treatment interval of 7--95 months, median 22 months and mean 28 months. One graft was lost to an acute rejection reaction that occurred in association with a flu-like syndrome 8 months after the conversion was started. It is concluded that in the patient with documented stability of the graft, every other day steroid administration is a successful immunosuppressive regimen.