Corticosteroids in Solid Organ Transplantation: Update and Review of the Literature

Abstract

Corticosteroids have been a constant in immunosuppressive regimens since the beginning of solid organ transplantation. Although the use of corticosteroids allowed the advancement of transplantation in the early years, this came at the price of numerous adverse events for patients. As the survival of transplanted organs has risen over the past several years, increasing attention has been focused on the management of long-term complications. Many of these long-term complications are directly related to the toxicities of immunosuppressive agents. Due to these toxicities, we have seen a resurgence in immunosuppressive protocols that utilize regimens designed to minimize these long-term complications. This has been accomplished by avoiding, reducing or withdrawing one or more medications from the multi-drug regimens. Corticosteroids, with their plethora of side affects, have been of major interest to the transplant community in terms of minimizing side affects by limiting exposure.