The researchers compared 2 schedules of steroid treatment of acute hepatic cellular rejection in patients who undergo liver transplant.
They published their findings in the June issue of Liver Transplantation.
A total of 38 eligible patients, with grade II or III acute hepatic cellular rejection, were randomized to receive 2 different high-dose methylprednisolone schedules.
Of these, 18 patients were randomized in Group A (intravenous dose of 1000 mg of methylprednisolone, followed by a 6-day taper from 200 to 20 mg/day).
The other 20 patients were randomized in Group B (intravenous dose of 1000 mg of methylprednisolone for 3 consecutive days).
|Resolution of rejection:|
Group A: 83%
Group B: 50%
| Liver Transplantation |
The response to treatment was evaluated by means of a second liver biopsy.
The treatment of Group A proved to be more effective than treatment of Group B.
The resolution of acute hepatic cellular rejection was observed in 83% of cases in Group A and 50% of cases in Group B.
The investigators also found that treatment of Group A was safer than treatment of Group B.
Patients randomized in Group B showed a higher prevalence of infections (90% of cases versus 56% of cases). These were mainly due to bacterial (80% versus 50%) and viral (50% versus 17%) agents.
Roberta Volpin, of the University of Padua, concluded on behalf of fellow authors, "Intravenous administration of 1000 mg of methylprednisolone, followed by a 6-day taper from 200 to 20 mg/day, is more effective and safer than intravenous dose of 1000 mg of methylprednisolone for 3 consecutive days, in the treatment of acute cellular rejection in patients with liver transplantation."