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Steroid-Free Liver Transplants

A new study out of Belgium suggests children undergoing liver transplants may fare better if they don't receive steroids. //

Ever since organ transplants began, steroids have played a major role in helping recipients fend off rejection of their new organ. However, the treatment is not without side effects, especially in children. Steroids have been linked to infections, high blood pressure, elevated blood cholesterol, and impaired growth in young patients.

Researchers in this study tested the use of a newer anti-rejection drug in a group of 20 children needing liver transplants to see if the new drug might solve some of these problems. The patients received a combination therapy in which the drug basiliximab replaced steroids in an otherwise standard treatment.

The children were all followed for at least a year. Investigators compared outcomes for the group with those from a similar group of 20 children who had received liver transplants in the past and had been given steroid treatment.

The study found children on the newer combination of medications had a 25 percent graft rejection rate after one year vs. 50 percent among those who had received steroid therapy following their transplant. Children on the new treatment also had a reduced need for high blood pressure medications and appeared to begin catching up on growth soon after their transplant. Cholesterol levels at the one-year follow up were about the same in the children who received the new treatment as those seen among kids who received the standard treatment with steroids.

Author Raymond Reding notes, "Our results suggest no harmful effect of steroid avoidance for graft acceptance, but this finding will need to be confirmed after extended follow-up."


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