Current status of glucocorticoid usage in solid organ transplantation

Table 1 Effect of pretreatment of transplant donors with methylprednisolone on outcomes of solid organ transplantation

Type of the study	Type of SOT	Follow-up duration	Findings
RCT[57]	Liver	6 mo	Significant lower liver enzymes in GC vs placebo group at 1st and 10th d after transplantation; No difference in PNF rate between groups (2 of 50 patients in GC and 3 of 50 patients in the placebo group); Lower acute rejection during 6 mo in GC group (22% vs 36%; P < 0.05)
RCT[60]	Liver	Maximum 3 yr	No difference in liver enzymes between GC and placebo groups during 1st wk after transplantation; Acute rejection during 3 mo after transplantation was 24% in each group; 1 yr graft loss of 15% in GC and 24% in the placebo group (P = 0.41); Relative risk of acute rejection in GC vs placebo group: 1.02 (95%CI: 0.5-2.1; P = 1); Relative risk of mortality in GC vs placebo group: 0.63 (95%CI: 0.29-1.36; P = 0.31)
Meta-analysis of two above RCTs[61]	Liver	Maximum 6 mo	Risk ratio for incidence of acute rejection during 1 mo to 6 mo after transplantation: 0.72 (95%CI: 0.44-1.19; P = 0.2)
RCT[59]	Kidney	5 yr	3 mo BPAR: 10% in GC and 12% in placebo group (P = 0.468); 5 yr graft survival: 84% in GC and 82% in placebo group (P = 0.941); Mean eGFR at 5 yr: 47 mL/min/1.73 m2 in GC and 48 mL/min/1.73 m2 in placebo group (P = 0.756)

BPAR: Biopsy-proven acute rejection; CI: Confidence interval; eGFR: Estimated glomerular filtration rate; GC: Glucocorticoid; PNF: Primary non-function; RCT: Randomized clinical trial; SOT: Solid organ transplantation.