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Related Experiment Videos

[Indication for the steroid therapy for acute rejection]

T Tanaka1, K Suzuki, R Tsugawa

  • 1Department of Urology, Kanazawa Medical University.

Hinyokika Kiyo. Acta Urologica Japonica
|July 10, 1998
PubMed
Summary

Kidney transplant recipients experiencing steroid-resistant rejection (SRR) had significantly lower 5-year graft survival. Treatment outcomes for SRR varied, with no significant difference in survival between different intervention groups.

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Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Clinical Medicine

Context:

  • 103 kidney transplantations performed between 1986 and 1997.
  • Graft sources included living related (79), living unrelated (1), and cadaveric (23) donors.
  • Standard immunosuppression involved cyclosporine (CYA), azathioprine (AZ), and methylprednisolone (MP).

Purpose:

  • To evaluate the incidence and impact of steroid-resistant rejection (SRR) on kidney graft survival.
  • To compare the efficacy of different treatment modalities for SRR.
  • To correlate Banff classification of rejection with steroid responsiveness.

Summary:

  • 14.9% of kidney grafts (20/103) developed steroid-resistant rejection (SRR).
  • 5-year graft survival was significantly lower in patients with SRR (57.9%) compared to those with no rejection (92.9%) or steroid-responsive rejection (85.6%).

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  • Treatments for SRR included methylprednisolone pulse, plasma exchange, OKT3, and others, but no significant differences in 5-year graft survival were observed among these groups.

    • Impact:

    • Steroid-resistant rejection poses a significant threat to long-term kidney graft survival.
    • Current treatment strategies for SRR may not offer distinct survival advantages.
    • Further research is needed to optimize SRR management and improve transplant outcomes.