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Steroid free kidney transplant

Hi,Has anyone heard about steroid free kidney transplant program.Here in India I recently came to know that a transplant centre is running such procedure. Whats your view on this. What are the pros and cons of not having wysolone in our daily transplant meds. Is it popular in any other country and what is the long term success rate. Any idea?

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  • hi  i am 7 months post liver and kidney transplant, i am still on prednisone 5 mg a day for a while yet cause my white blood cell count is extremely low

  • I dont do steroids.. Cellcept and prograf 8yrs eGfr is 85.  Bun 18 creatine 0.78....  Here in united states some are on steroids....

  • In the US, there are over 120 transplant centers that use a steroid-free protocol. Many have been around since the millennium. I believe the long-standing goal of transplant medicine is to eventually reduce/curtail the need for immunosuppression meds, by whatever means.  Some of our members are on steroid-free protocols. The face of transplantation is always changing and advancing.

    One thing that hasn't changed is the use of high dose steroids in the event of a rejection episode. Solumedrol (IV Prednisone over 100 mg) is still the "go to" treatment for almost all immune response incidents. There is hope that someday, the need for steroids (and their vile side effects and high costs) will end and newer discoveries will help recipients live a better life.

    The Mayo Clinic - Steroid-free protocols in Organ Transplantation

    NCBI info - Will steroids-free protocols become the standard for ma...

    A Study (SAILOR) of steroid-free survival rates

    Kidney Transplant - Steroid-free immunosuppression protocols
    The Mayo Clinic Kidney Transplant Program offers expert kidney transplantation and related care for people with kidney failure and other problems wit…
  • I listen to transplant doctors. I had my kidney 19 years. I took the drugs they prescribed. I got the gift of life
  • As for wysolone(same as prednisone), the pros are that its anti-inflammatory. Lots of cons/ side effects. So the sooner you get off it the better. Having said that, some people always need to take it. depends on their medical condition. People with conditions other than transplant do take it as well. So talk to your doctor and take a 2nd opinion since you are `1yr post Tx. Enjoy

  • As Carla said, I had steroids for the first month roughly. they started tapering down per day. I was on prednisone. The max I took was 75mg per day. but they kept reducing it. 

    Finally, after ~1.5 months, i stopped taking it. I had my transplant in India as well btw. Pune actually. Talk to your doctor. 

    • Actually I am on wysolone still and in my hospital they never stop wysolone. Minimum 5mg dose goes on forever. About this steroid free program I heard from a friend who went to Coimbatore to enquire about the process. So I just wanted to know if that actually works. For me as per my doctor I will have to take wysolone for lifetime. Bdw Pune.. Which hospital?
      • Hello Priyanka,

        It was the same case with me aswell.Its been 2 years 4 months still I am on Omna Cortil 5 mg and this needs to be used for life time per my last conversation with my Primary physician or Nephrologist here in Hyderabad.

        Need to talk to him once again on Steroid free TX program..

         

        Thx

        Prasad

         

  • Hi priyanka. I signed up with my tx center (U of Mn Fairview) specifically because they were offering steroid avoidance. I already had significant bone loss from adynamic bone disease due to my diabetes and I didn't want to add the prednisone to the mix. I figured that if I had rejection problems, they could always add the pred.

    I got my kidney (from my cousin, 1/6 match) in 2002. I got my deceased donor pancreas in 2008. And (knock on wood for luck) I have not yet had an episode of rejection. So being steroid free is working very well for me.

    As for the long term success, there were two studies that came out in about 2010 or so. One from my tx center and one from Chicago (I think). And what they found was that after 10 years of steroid avoidance there was really no significant difference between roughly equivalent kidney transplant populations. Those on prednisone and those not. No real differences of rates of rejection or loss of organ. I don't know if there have been any additional follow up studies, but I do know that since 2002 (when it was very rare) more and more centers are going the no-steroid route.

    • Thanx Cora for the reply. I read that research was going on it. Good to hear that it actually works. In India its still rare. So I was curious to know about the result as I couldnt find much on the internet.
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