De fi ning a Steroid Withdrawal Protocol in a newly established Kidney Transplantation Unit

Chitungwiza Central Hospital, a 500 bedded tertiary teaching hospital located in the city of Harare in the Southern African country of Zimbabwe, is at an advanced stage of establishing a kidney transplantation unit with the guidance of International Society of Nephrology. It is anticipated that the unit will initially perform at least fi ve (5) kidney transplant operations per month when it becomes fully functional. The recommended immunosuppression protocol includes induction by rabbit anti-thymocyte globin (rATG) and maintenance on prednisolone, tacrolimus (TAC) and mycophenolate mofetil (MMF), and does not consider steroid withdrawal. This review is aimed to critically review our unit’s recommended policy of maintaining steroids as part of immunosuppression versus steroid withdrawal strategies implemented by other kidney transplant units. The review considers the advantages and disadvantages of various steroid withdrawal or avoidance protocols using published evidence.

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  2017

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  DOI 10.17352/aot.000009
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