Steroid withdrawal in mycophenolate mofetil-treated renal allograft recipients

Transplantation. 1997 Jun 15;63(11):1688-90. doi: 10.1097/00007890-199706150-00026.


Background: Acute rejection is an inherent risk of the withdrawal of steroids in renal allograft recipients. Mycophenolate mofetil is a potent immunosuppressant that, when given with cyclosporine (CsA), reduces the incidence of acute rejection and may facilitate discontinuation of steroids without increasing the risk of rejection.

Methods: In an open pilot study, steroids were withdrawn from 26 adult cadaveric kidney transplant recipients. Corticosteroids were discontinued between 4 and 30 (mean 17) months after transplantation, and steroid-free follow-up ranged from 7 to 18 (mean 10) months.

Results: Mean CsA doses, CsA blood levels, and serum creatinine at the time of steroid withdrawal and at last patient visit after cessation of steroids were 4.2+/-1.2 mg/kg/day and 3+/-0.8 mg/kg/day (P<0.001), 170+/-53 ng/ml and 113+/-34 ng/ml (P<0.001), and 133+/-36 microM/L and 130+/-37 microM/L (NS), respectively. No rejection episodes occurred after steroid withdrawal.

Conclusions: This open study shows that corticosteroids can be safely and successfully withdrawn from renal allograft recipients receiving CsA and mycophenolate mofetil.

MeSH terms

  • Acute Disease
  • Adult
  • Creatinine / blood
  • Cyclosporine / blood
  • Female
  • Graft Rejection / chemically induced*
  • Graft Rejection / prevention & control
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Kidney / physiology
  • Kidney Transplantation / immunology*
  • Male
  • Middle Aged
  • Mycophenolic Acid / analogs & derivatives*
  • Mycophenolic Acid / therapeutic use
  • Steroids*
  • Substance Withdrawal Syndrome*


  • Immunosuppressive Agents
  • Steroids
  • Cyclosporine
  • Creatinine
  • Mycophenolic Acid