High dose (bolus) intravenous methylprednisolone at the time of kidney homotransplantation.

A completely randomized double-blind study of bolus methylprednisolone versus dextrose in water, administered at the time of human kidney transplantation, has failed to demonstrate any beneficial effect of the steroid therapy. No differences were observed in the number of complete, irreversible graft rejections, the number of acute rejection episodes, or the number of postoperative steroid boluses administered in the treated or the control groups. Similarly, there were no differences in the mean serum creatinines at 30, 60, 90 days post-transplantation. There was a slight increase in mortality and incidence of complications in the group of patients receiving an intravenous bolus of methylprednisolone at the time of transplantation as compared to controls. The failure to demonstrate any beneficial effect and the slight increased mortality and morbidity associated with the bolus methylprednisolone dosage makes this therapy unjustifiable.