Abstract
MYCOFENOLATE MOFETIL (MMF)–cyclosporine corticosteroid immunosuppression in kidney-transplanted patients has been shown to provide a significant reduction in the occurrence and severity of acute rejection and a tendency toward better 1-year survival in large multicenter trials, with an acceptable adverse events profile. The corticosteroid dosing protocol remains questionable. One multicenter trial investigated the safety of steroid withdrawal with a low starting dose. A significantly higher incidence of steroid-sensitive acute rejection was found. At our institution, a single-center trial was carried out to assess the influence of high-/low-dose corticosteroid in combination with an MMF–and a cyclosporine microemulsion formulation (CsA-MOF) in kidney-transplanted recipients. In routine practice at our department, first-line treatment (steroid bolus) of acute rejection is based on clinical evidence, as in many transplantation centers; therefore, only steroid-resistant acute rejections were biopsy proven during the trial.
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