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Risks and Benefits

Arnold G. Diethelm, MD; William A. Sterling, MD; Marshall W. Hartley, PhD; Jean M. Morgan, MD

Arch Surg. 1976;111(8):867-870.

Abstract
• Forty-five patients receiving renal allografts were gradually converted from daily to alternate-day prednisone therapy. Indications for conversion included aseptic necrosis, growth retardation in children and adolescents, obesity, diabetes, cataract formation, and cosmetic appearance. Eight of the 45 patients developed acute or chronic rejection during or just after completion of alternate-day steroid therapy. The remaining 37 patients had a notable decrease in the degree of hypercorticism, with return of growth in children and adolescents. However, there was no improvement once aseptic necrosis or cataract formation had occurred. Although the use of alternate-day prednisone therapy is of benefit in reducing the untoward side effects of corticosteroids, the risk of precipitating allograft rejection is a significant threat and must be carefully considered whenever this form of treatment is undertaken.

(Arch Surg 111:867-870, 1976)

Author Affiliations
From the departments of surgery (Drs Diethelm, Sterling, and Morgan) and pathology (Dr Hartley), University of Alabama Medical Center, and the Veterans Administration Hospital, Birmingham. Dr Sterling is now with the Department of Surgery, University of New Mexico School of Medicine, Albuquerque.

Footnotes
Accepted for publication March 16, 1976.

Reprint requests to Department of Surgery, University of Alabama Medical Center, University Station, Birmingham, AL 35294 (Dr Diethelm).

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