LONG-TERM EFFECTS OF STEROID WITHDRAWAL IN KIDNEY-TRANSPLANTATION

The long-term graft function after withdrawal of steroids from mainten ance immunosuppression was analyzed in 98 kidney recipients (59 on cyc losporin monotherapy, 39 on cyclosporin plus azathioprine) who had not developed an early rejection episode when prednisolone was discontinu ed. Seven years after steroid withdrawal the probability of an increas e in serum creatinine ( > 20 % of baseline levels) was 51 %. The incre ase in creatinine was associated with sclerosing arteriopathy as a mar ker of chronic rejection in 29 of 43 graft biopsies. The addition of a zathioprine had no effect on the stability of long-term graft function and did not influence the 7-year graft survival rate in this highly s elected group of patients.