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Following a liver transplant, patients usually use calcineurin inhibitors (immunosuppressant) and steroids to prevent rejection and increase survival rates. However, long term use of these drugs can lead to complications. For example, steroids can cause diabetes, high cholesterol and hypertension which may increase the likelihood of heart disease and possibly even death. The incidence of these complications can be reduced by earlier cessation of steroid use but this in turn increases the rejection rate. Rejection can be alleviated by high IV dose of steroid over a short time. A study involving 174 liver transplant patients found that after 6 months 24.4% of patients taking long term steroids and 38.1% of the placebo group had an acute rejection. The incidence of high cholesterol and hypertension was the same for both groups but 22.2% of the steroid group and 14.3% of the placebo group developed diabetes. After 12 months, the steroid group had a 25.6% rejection rate compared to 39.3% in the placebo group. The diabetes rate was the same in both groups. Thus researchers concluded that early withdrawal from steroid use increased the rejection rate but steroid continuation increased the risk of diabetes.
Source: summary of medical news story as reported by Science Daily
About: Early cessation of steroid following liver transplant increases rate of rejection
Date: 16 December 2004
Source: Science Daily
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