Steroids Blog

If steroids are withdrawn at early stage post liver transplantation, a reduced tolerance and higher rejection incidences to glucose may be considered to necessitate diabetes treatment.

The finding was suggested after the first double-blind placebo-controlled study was conducted to examine the early steroid withdrawal effects. This study was published in an issue of Liver Transplantation, the official journal of the American Association for the Study of Liver Diseases (AASLD) and the International Liver Transplantation Society (ILTS).

From News-Medical.Net:

“Although the incidence of acute rejection in the placebo group was increased, it was easily controlled in most of the cases and did not affect long-term graft histology or survival,” the authors note, adding that the increase may ultimately be acceptable if steroids could be eliminated. However, the main goal of steroid elimination is to reduce metabolic complications and this study showed no difference in cholesterol or hypertension, with a trend toward a decreased incidence of diabetes in the placebo group.

The authors conclude: “Indeed, while there are many arguments in favor of corticosteroid withdrawal beyond 3 months posttransplantation, in terms of safety and efficacy, our study demonstrates that earlier withdrawal at day 14 is not completely safe in terms of rejection, but seems efficient in terms of improvement of glucose tolerability,” which could decrease long-term mortality due to cardiovascular disease.

The study is expected to help members of the medical fraternity to handle complicated issues with a greater sense of caution.