Aggressive steroid weaning after cardiac transplantation is possible without the additional risk of significant rejection

Clinical Transplantation

Volumn 22, Issue 6, 2008, Pages 730-737

  Teuteberg, Jeffrey J ^a,b   Shullo, Michael ^a   Zomak, Rachelle ^a   McNamara, Dennis ^a   McCurry, Kenneth ^a   Kormos, Robert L ^a  

^a UNIVERSITY OF PITTSBURGH   (United States)

^b NONE   (United States)

Author keywords

Cardiac; CTX, cardiac transplantation; Heart; MMF, mycophenolate mofetil; Steroid; TAC, tacrolimus; Transplant; Weaning Abbreviations: AZA, azathioprine

Indexed keywords

AZATHIOPRINE; CALCINEURIN INHIBITOR; CYCLOSPORIN; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; METHYLPREDNISOLONE; MYCOPHENOLIC ACID 2 MORPHOLINOETHYL ESTER; PREDNISONE; STEROID; TACROLIMUS;

ADULT; AGED; ARTICLE; CARDIAC GRAFT REJECTION; CLINICAL PROTOCOL; CONTROLLED STUDY; DRUG BLOOD LEVEL; DRUG DOSE REDUCTION; DRUG EFFICACY; DRUG SAFETY; DRUG WITHDRAWAL; FEMALE; HEART DISEASE; HEART TRANSPLANTATION; HUMAN; IMMUNOSUPPRESSIVE TREATMENT; MAJOR CLINICAL STUDY; MALE; OVERALL SURVIVAL; PATIENT SAFETY; POSTOPERATIVE CARE; PRIORITY JOURNAL; RETROSPECTIVE STUDY; RISK ASSESSMENT; TREATMENT DURATION;

ADOLESCENT; ADULT; AGED; CHILD; FEMALE; GLUCOCORTICOIDS; GRAFT REJECTION; HEART TRANSPLANTATION; HUMANS; IMMUNOSUPPRESSIVE AGENTS; INCIDENCE; MALE; METHYLPREDNISOLONE; MIDDLE AGED; PREDNISONE; PROSPECTIVE STUDIES; RETROSPECTIVE STUDIES; WEANING; YOUNG ADULT;

EID: 56349128759     PISSN: 09020063     EISSN: 13990012     Source Type: Journal    
DOI: 10.1111/j.1399-0012.2008.00868.x     Document Type: Article

References (43)

1. Hagan ME, Holland CS, Herrick CM, Rasmussen LG. Amelioration of weight gain after heart transplantation by corticosteroid-free maintenance immunosuppression. UTAH Cardiac Transplant Program. J Heart Transplant 1990: 9: 382.
2. Price GD, Olsen SL, Taylor DO, O'Connell JB, Bristow MR, Renlund DG. Corticosteroid-free maintenance immunosuppression after heart transplantation: Feasibility and beneficial effects. J Heart Lung Transplant 1992: 11: 403.
3. Baran DA, Ashkar J, Galin ID et al. Tacrolimus and new onset diabetes mellitus: The effect of steroid weaning. Transplant Proc 2002: 34: 1711.
4. Khoury N, Kriaa F, Hiesse C et al. Posttransplant diabetes mellitus in kidney transplant recipients under tacrolimus immunosuppression. Transplant Proc 2000: 32: 2763.
5. Laskow DA, Neylan JF III, Shapiro RS, Pirsch JD, Vergne-Marini PJ, T omlanovich SJ. The role of tacrolimus in adult kidney transplantation: A review. Clin Transplant 1998: 12: 489.
6. Nieuwenhuis MG, Kirkels JH. Predictability and other aspects of post-transplant diabetes mellitus in heart transplant recipients. J Heart Lung Transplant 2001: 20: 703.
7. Reid KR, Menkis AH, Novick RJ et al. Reduced incidence of severe infection after heart transplantation with low-intensity immunosuppression. J Heart Lung Transplant 1991: 10: 894.
8. Olivari MT, Jessen ME, Baldwin BJ et al. Triple-drug immunosuppression with steroid discontinuation by six months after heart transplantation. J Heart Lung Transplant 1995: 14: 127.
9. Keogh A, Macdonald P, Harvison A, Richens D, Mundy J, Spratt P. Initial steroid-free versus steroid-based maintenance therapy and steroid withdrawal after heart transplantation: Two views of the steroid question. J Heart Lung Transplant 1992: 11: 421.
10. Becker DM, Chamberlain B, Swank R et al. Relationship between corticosteroid exposure and plasma lipid levels in heart transplant recipients. Am J Med 1988: 85: 632.
11. Renlund DG, Bristow MR, Crandall BG et al. Hypercholesterolemia after heart transplantation: Amelioration by corticosteroid-free maintenance immunosuppression. J Heart Transplant 1989: 8: 214.
12. Taylor DO, Thompson JA, Hastillo A et al. Hyperlipidemia after clinical heart transplantation. J Heart Transplant 1989: 8: 209.
13. Lee KF, Pierce JD, Hess ML, Hastillo AK, Wechsler AS, Guerraty AJ. Cardiac transplantation with corticosteroid-free immunosuppression: long-term results. Ann Thorac Surg 1991: 52: 211.
14. Taylor DO, Bristow MR, O'Connell JB et al. Improved long-term survival after heart transplantation predicted by successful early withdrawal from maintenance corticosteroid therapy. J Heart Lung Transplant 1996: 15: 1039.
15. Felkel TO, Smith AL, Reichenspurner HC et al. Survival and incidence of acute rejection in heart transplant recipients undergoing successful withdrawal from steroid therapy. J Heart Lung Transplant 2002: 21: 530.
16. Opelz G, Dohler B, Laux G. Long-term prospective study of steroid withdrawal in kidney and heart transplant recipients. Am J Transplant 2005: 5: 720.
17. Yacoub M, Alivizatos P, Khaghani A, Mitchell A. The use of cyclosporine, azathioprine, and antithymocyte globulin with or without low-dose steriods for immunosuppression of cardiac transplant patients. Transplant Proc 1985: 17: 221.
18. Katz MR, Barnhart GR, Szentpetery S et al. Are steroids essential for successful maintenance of immunosuppression in heart transplantation? J Heart Transplant 1987: 6: 293.
19. Renlund DG, O'Connell JB, Gilbert EM, Watson FS, Bristow MR. Feasibility of discontinuation of corticosteroid maintenance therapy in heart transplantation. J Heart Transplant 1987: 6: 71.
20. Esmore DS, Spratt PM, Keogh AM, Chang VP. Cyclosporine and azathioprine immunosuppression without maintenance steroids: A prospective randomized trial. J Heart Transplant 1989: 8: 194.
21. Spratt P, Esmore D, Keogh A, Chang V. Comparison of three immunosuppressive protocols in cardiac transplantation. Transplant Proc 1989: 21: 2481.
22. Moore CK, Bristow MR, Renlund DG, Rasmussen LG, O'Connell JB. Long-term morbidity of cyclosporine with corticosteroid-free maintenance immunosuppression in cardiac transplantation. Transplant Proc 1990: 22(3 Suppl. 1): 25.
23. Prieto M, Lake KD, Pritzker MR et al. OKT3 induction and steroid-free maintenance immunosuppression for treatment of high-risk heart transplant recipients. J Heart Lung Transplant 1991: 10: 901.
24. Pritzker MR, Lake KD, Reutzel TJ et al. Steroid-free maintenance immunotherapy: Minneapolis Heart Institute experience. J Heart Lung Transplant 1992: 11: 415.
25. Miller LW, Wolford T, Mc Bride LR, Peigh P, Pennington DG. Successful withdrawal of corticosteroids in heart transplantation. J Heart Lung Transplant 1992: 11: 431.
26. Keogh A, Macdonald P, Mundy J, Chang V, Harvison A, Spratt P. Five-year follow-up of a randomized double-drug versus triple-drug therapy immunosuppressive trial after heart transplantation. J Heart Lung Transplant 1992: 11: 550.
27. Livi U, Luciani GB, Boffa GM et al. Clinical results of steroid-free induction immunosuppression after heart transplantation. Ann Thorac Surg 1993: 55: 1160.
28. Delgado D, Arazi HC, Sellanes M et al. Study of early corticosteroid withdrawal in cardiac transplantation. Transplant Proc 1999: 31: 2524.
29. Grimm M, Rinaldi M, Yonan NA et al. Superior prevention of acute rejection by tacrolimus vs. cyclosporine in heart transplant recipients - a large European trial. Am J Transplant 2006: 6: 1387.
30. Kobashigawa JA, Miller LW, Russell SD et al. Tacrolimus with mycophenolate mofetil (MMF) or sirolimus vs. cyclosporine with MMF in cardiac transplant patients: 1-year report. Am J Transplant 2006: 6: 1377.
31. Hamour IM, Lyster HS, Burke MM, Rose ML, Banner NR. Mycophenolate mofetil may allow cyclosporine and steroid sparing in de novo heart transplant patients. Transplantation 2007: 83: 570.
32. Mehra MR, Uber PA, Park MH, Ventura HO, Scott RL. Corticosteroid weaning in the tacrolimus and mycophenolate era in heart transplantation: clinical and neurohormonal benefits. Transplant Proc 2004: 36: 3152.
33. Baran DA, Galin ID, Segura L et al. Tacrolimus and cardiac transplantation: A comparison of monotherapy and steroid-dependent patients. Transplant Proc 2002: 34: 1845.
34. Baran DA, Segura L, Kushwaha S et al. Tacrolimus monotherapy in adult cardiac transplant recipients: Intermediate-term results. J Heart Lung Transplant 2001: 20: 59.
35. Lubitz SA, Baran DA, Alwarshetty MM et al. Improved survival with statins, angiotensin receptor blockers, and steroid weaning after heart transplantation. Transplant Proc 2006: 38: 1501.
36. Jain A, Marcos A, Reyes J et al. Tacrolimus for primary liver transplantation: 12 to 15 years actual follow-up with safety profile. Transplant Proc 2005: 37: 1207.
37. Jordan ML, Chakrabarti P, Luke PP et al. Steroid withdrawal for pancreas transplants under tacrolimus immunosuppression. Transplant Proc 2001: 33: 1655.
38. Pascual J, van Hooff JP, Salmela K, Lang P, Rigotti P, Budde K. Three-year observational follow-up of a multicenter, randomized trial on tacrolimus-based therapy with withdrawal of steroids or mycophenolate mofetil after renal transplant. Transplantation 2006: 82: 55.
39. Tan JY, Zhao N, Wu TX et al. Steroid withdrawal increases risk of acute rejection but reduces infection: A meta-analysis of 1681 cases in renal transplantation. Transplant Proc 2006: 38: 2054.
40. Anil Kumar MS, Khan S, Ranganna K, Malat G, Sustento-Reodica N, Meyers WC. Long-term outcome of early steroid withdrawal after kidney transplantation in African American recipients monitored by surveillance biopsy. Am J Transplant 2008: 8: 574.
41. Taylor DO, Edwards LB, Boucek MM et al. Registry of the International Society for Heart and Lung Transplantation: Twenty-fourth official adult heart transplant report -2007. J Heart Lung Transplant 2007: 26: 769.
42. Taylor DO, Edwards LB, Boucek MM et al. Registry of the International Society for Heart and Lung Transplantation: Twenty-third official adult heart transplantation report - 2006. J Heart Lung Transplant 2006: 25: 869.
43. Miller LW. Steroid withdrawal in heart transplantation. J Heart Lung Transplant 1992: 11: 401.