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August 1972

Rejection Crises in Human Renal Transplant Recipients: Control With High Dose Methylprednisolone Therapy

Author Affiliations

Ann Arbor, Mich
From the Section of General Surgery (Drs. Turcotte, Feduska, and Carpenter) and the departments of internal medicine (Dr. McDonald), and pediatrics, and pharmacology (Dr. Bacon), University of Michigan Medical Center, Ann Arbor.

Arch Surg. 1972;105(2):230-236. doi:10.1001/archsurg.1972.04180080084014

Ninety-five of 103 episodes of acute rejection encountered in recipients of 112 renal allografts were halted with one to four intravenous "pulses" of methylprednisolone sodium succinate, 30 mg/kg. Cumulative transplant and recipient survival improved after introduction of pulse therapy. No serious complications were observed from this treatment. With gas chromatography, the serum half-life of methylprednisolone was determined to be 2.30 ± 0.70 hours in humans. The peak serum concentration of prednisolone was lower, and the duration of high serum concentration longer after oral administration of prednisone, 30 mg/kg. Intravenous administration of massive doses of methylprednisolone every 48 to 72 hours reversed or halted 92% of acute rejection episodes, did not cause any obvious acute or chronic morbidity, and provided a transient high peak concentration of methylprednisolone alternating with longer periods of low serum levels.

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