Steroid minimization for sirolimus-treated renal transplant recipients

Steroids are associated with a myriad of post-transplant side effects. Therefore, as new immunosuppressive drugs have been developed, attempts have been made to minimize steroid exposure. Sirolimus (SRL) has been demonstrated to have efficacy in early and late post-transplant immunosuppression. Accordingly, numerous trials have studied steroid minimization (early and late post-transplant) in the context of SRL-containing protocols (either with or without a calcineurin inhibitor). We herein review these trials and show that recent studies have determined that both late steroid withdrawal and early rapid discontinuation can be successful with SRL immunosuppression.