Alternate-day XXXX in the maintenance immunosuppressive therapy after orthotopic liver transplantation.

@entity1 @entity2835 @entity82 @entity5881 @entity1956 @entity500 @entity229 @entity879 @entity1126 @entity205 @entity157 @entity255
Glucocorticoids have been an important part of maintenance immunosuppressive therapy following orthotopic liver transplantation (OLT). However, long-term daily glucocorticoid use is associated with a high incidence of unpleasant side effects. In an effort to minimize side effects while maintaining adequate immunosuppression, we have treated 48 adult @entity1 with low dose alternate-day @entity229 , 15 mg q.o.d. Pre-OLT diagnoses included @entity2835 (16 @entity1 ), @entity5881 (8 @entity1 ), sclerosing @entity255 (8 @entity1 ), cryptogenic @entity82 and/or non-A, @entity1956 (11 @entity1 ), @entity879 (3 @entity1 ), and @entity157 and @entity1126 (1 @entity1 each). Conversion to alternate-day @entity229 was attempted when @entity1 were clinically stable and the daily @entity229 dose was 15 mg. The average interval between OLT and beginning of the conversion to alternate-day @entity229 was 38 weeks. The mean time for conversion to alternate-day @entity229 was 35 weeks, but decreased as more experience was gained. The mean follow-up was 106 weeks. Cushingoid side effects diminished in all. In 47 of the 48 @entity1 , there were no clinical laboratory or histologic changes suggestive of rejection after the initiation of alternate-day @entity229 . A single episode of rejection occurred during the taper. This episode responded promptly to increased glucocorticoid therapy, and the @entity1 was easily converted to alternate-day @entity229 at a later date. There was no increase in concurrent immunosuppressives dosage after the conversion. Alternate-day @entity229 is effective and safe for chronic immunosuppression after OLT in @entity1 receiving @entity205 and @entity500 .
