Reevaluation of steroid tapering after steroid pulse therapy for heart rejection.
J Heart Lung Transplant
; 11(5): 913-9, 1992.
Article
in En
| MEDLINE
| ID: mdl-1420239
ABSTRACT
A retrospective analysis was conducted to determine the efficacy and complications resulting from steroid pulse therapy, with or without a steroid taper, in 93 episodes of heart transplant rejection that occurred in 72 patients (58 men, 14 women; mean age, 47.6 years). Each rejection episode was classified according to severity (Texas Heart Institute endomyocardial biopsy scale) and the treatment. Group 1 included 25 episodes of grade 7, 8, 9, or 10 rejection (International Society for Heart Transplantation [ISHT] grade IIIB or IV) that were treated with high-dose methylprednisolone (2.5 to 3.0 gm) and a steroid taper of 1.75 gm over 30 days. Group 2 included 16 episodes of rejection, with the severity of rejection and methylprednisolone pulse therapy being similar to that in group 1, but without a steroid taper. The results of treatment in group 1 were compared with those in group 2. Group 3 included 12 episodes of grade 5, 6, or 7 rejection (ISHT grade IIIA or IIIB) that were treated with moderate-dose methylprednisolone (1.0 to 2.0 gm) and a steroid taper, as described. Group 4 included 40 episodes of rejection, with the severity of rejection and methylprednisolone therapy being similar to that of group 3, but without a steroid taper. The results of treatment in group 3 were compared with those in group 4. No statistically significant differences were found among the groups regarding subsequent episodes of rejection or infection within 3 months of treatment. No statistically significant difference was noted among the groups in the number of rejection episodes requiring additional therapy to control the rejection.(ABSTRACT TRUNCATED AT 250 WORDS)
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Methylprednisolone
/
Prednisone
/
Heart Transplantation
/
Graft Rejection
Type of study:
Etiology_studies
/
Observational_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Heart Lung Transplant
Journal subject:
CARDIOLOGIA
/
TRANSPLANTE
Year:
1992
Document type:
Article