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Related Experiment Videos

Are there non-steroid-dependent rejection episodes?

J Crosnier, H Kreis, J M Descamps

    Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association
    |January 1, 1980
    PubMed
    Summary
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    Adding anti-thymocyte globulin (ATG) to immunosuppression significantly reduced steroid needs and improved kidney survival post-transplant. A separate pilot study suggests some early renal failures may resolve without steroids.

    Area of Science:

    • Nephrology
    • Immunology
    • Transplantation Medicine

    Background:

    • Steroid therapy in transplant recipients can lead to adverse effects.
    • Reducing steroid dosage or finding alternatives is crucial for long-term transplant success.

    Purpose of the Study:

    • To evaluate the efficacy of anti-thymocyte globulin (ATG) in reducing steroid requirements in transplant patients.
    • To explore the potential of nonsteroid anti-inflammatory (NSAI) drugs as steroid replacements.
    • To investigate early acute renal failure episodes in the absence of steroid therapy.

    Main Methods:

    • Two randomized studies were conducted.
    • Study 1: 50 transplant recipients received azathioprine and prednisolone, with ATG added to the experimental group.
    • Study 2: 15 transplant recipients were assigned to groups receiving either standard care or NSAI drugs instead of steroids.

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    Main Results:

    • The ATG group showed significantly fewer renal failure episodes and lower steroid requirements compared to the control group.
    • Two-year kidney survival was 79% in the ATG group versus 52% in the control group.
    • The pilot NSAI study indicated that early acute renal failure episodes may improve spontaneously without steroids.

    Conclusions:

    • ATG is effective in reducing steroid dosage and improving outcomes in transplant recipients.
    • NSAI drugs show potential as steroid alternatives, warranting further investigation.
    • Early acute renal failure in transplant patients might have an immunological basis and could potentially resolve without steroid intervention.