Steroid treatment for routine immunosuppression in cadaver renal transplantation. A survey of hospitals.

A review of data from 22 hospitals in the U.S. and Canada, comprised of information on 1700 kidney transplant patients, shows a consistent pattern with respect to usage of steroids both as routine treatment and for rejection episodes. High doses are associated with greater patient mortality. Graft survival is also adversely affected by very high doses, but only in the immediate post-transplant period. Our data suggest that for optimal graft and patient survival the dosage of steroids should be less than 150 mg/day of methylprednisolone on days 1-3, less than 50 mg/day of prednisone on days 4-21, less than 30 mg/day on days 22-30, and less than 20 mg/day between one mo and one yr.