Steroid withdrawal from tacrolimus-based therapy in renal transplant patients

Tacrolimus, a macrolide derived from the fungus Streptomyces tsukubaensis, has been shown in clinical trials to effectively reduce the incidence of acute rejection in kidney transplantation. Analysis of data shows that the reduced incidence of moderate to severe acute rejection episodes with tacrolimus is irrespective of whether the diagnosis was based on clinical signs and symptoms, local biopsy reading, or blinded central review of the biopsies. The potent immunosuppressive action of tacrolimus prompted us with the idea to wean off corticosteroid therapy, a major cause of long- term complications in renal transplant recipients. The aim of this study was to evaluate safety and efficacy of withdrawing corticosteroid therapy 6 months after transplantation, in a group of 60 renal allograft recipients immunosuppressed with tacrolimus plus mycophenolate mofetil and steroid.