Early Steroid Withdrawal after Liver Transplantation: The Canadian Tacrolimus versus Microemulsion Cyclosporin A Trial: 1-year Follow-up

Paul Greig, University of Toronto
Leslie Lilly, University of Toronto
Charles Scudamore, University of British Columbia
Siegfried Erb, University of British Columbia
Eric Yoshida, University of British Columbia
Norman Kneteman, University of Alberta
Vince Bain, University of Alberta
Cameron Ghent, The University of Western Ontario
Paul Marotta, The University of Western Ontario
David Grant, The University of Western Ontario
William Wall, The University of Western Ontario
Jean Tchervenkov, McGill University
Jeffrey Barkun, McGill University
Andre Roy, University of Montreal
Denis Marleau, University of Montreal
Vivian McAlister, Dalhousie University
Kevork Peltekian, Dalhousie University

Article comments

Dr. Vivian McAlister is currently a faculty member at The University of Western Ontario.

Abstract

Corticosteroid therapy contributes significant toxicity to liver transplantation. The safety and efficacy of early steroid withdrawal were determined in patients treated with either tacrolimus or microemulsion cyclosporin A (micro-CsA). The primary outcome was the proportion of patients who were steroid-free 1 year posttransplantation. From the seven Canadian adult liver transplant centers, 143 patients were randomly allocated oral treatment with either tacrolimus (n = 71) or micro-CsA (n = 72), together with corticosteroids and azathioprine. Eligibility criteria for steroid withdrawal included freedom from acute rejection for a minimum of 3 months, and prednisone