Trends in the use of glucocorticoids in renal transplantation

Abstract

Over the past 40 years, corticosteroids have played a key role in the evolution of successful organ transplantation. As early as 1951, Billingham and colleagues (1) demonstrated that the immune-modulating effects of corticosteroids prevented rejection and promoted survival of rabbit skin homografts. In 1963, Goodwin et al.(2) described the effectiveness of large doses of corticosteroids in suppressing and reversing rejection episodes in one of the first technically successful human renal allograft transplants. The use of corticosteroids to control acute allograft rejection was a breakthrough that allowed renal transplantation to become a routine procedure. During the late 1950s, the immunosuppressive activity of an AZA metabolite also was recognized (3, 4).