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Different survival of long-term kidney transplant recipients treated with daily or alternate day corticosteroids.

To define the effect of different immunosuppressive treatments on survival of long-term kidney transplant recipients, we have followed, for a period of four years, a group of 18 long-term survivors (more than three years) of kidney transplantation who were subjected to two different corticosteroid regimens (daily or alternate day corticosteroids) plus azathioprine. THis study not only confirms that an alternate day corticosteroid treatment reduces the incidence of infectious episodes and of side effects, but also suggests that it may steadily improve the survival of these patients. One of the six patients who performed an alternate day corticosteroid regimen died and only one lost renal graft function. On the contrary, three of the twelve patients who received daily corticosteroids died of causes related to immunosuppressive treatment, while another five patients lost renal graft function. A very low level of peripheral blood lymphocytes, of early E rosette and E rosette-forming cells was detected in patients who died of causes related to immunosuppressive treatment.