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Important: Protocol superseded July 2009 - see new version here at www.edren.co.uk.
That website is in development - you can ignore the 'This website is not ready' signs ONLY for the Transplant protocols. Others are not updated or fully transferred. |
This page describes the Edinburgh regimen for the use of the immunosuppressant Prednisolone.
prednisolone is normally reduced according to the following schedule:
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This schedule may be altered if rejection occurs.
All patients to receive Ranitidine (150 mgs od) along with Prednisolone.
After 3 months continue minimum of 5 mg or 7.5 mg if >75 kg in weight.
Keep on maintenance dose until the end of the first year and then review.
At one year, cessation of prednisolone should be considered - see steroid withdrawal protocol. Caution should be exercised in patients with an "increased risk" of rejection. Cautions relating to Steroid withdraal include:
Steroid withdrawal should be discussed with the patient and they should be informed of the risk of rejection. The steroids should be withdrawn according to the following schedule.
All patients should receive additional elemental calcium, this may be as one or two tablets per day depending on dietary intake.
- If GFR > 50 mls/min AdCalD3 (or similiar) should be used.
- If GFR < 50 mls/min Alfacalcidol and Calcichew should be used.
IV Pamidronate may be used in the initial post transplant period in patients with - known osteopenia or osteoporosis, a history of one or more previous transplants, 2 or more episodes of rejection (treated with high dose steroid therapy) or a history of previous disease management with steroids.
- Diet
- Weight
- Exercise
- Smoking cessation
Transplant protocols developed on the Edinburgh Transplant Unit. This page first published March 2002 by Amit Adlakha, updated in November 2006 and last modified
NOTE that the accuracy of any statements in this information CANNOT be guaranteed. It is published in the belief that it is correct, and we endeavour to keep it so - but we do make mistakes. Furthermore, over some subjects there are differing opinions, or differing degrees of certainty. We have usually not attempted to discuss these here because the aim has been to provide an immediate and brief guide. In all areas, prior medical knowledge is assumed. The EdRenHANDBOOK is not suitable for use by those without such a background. Contact us by email or at the address given at the foot of the contents page with any comments or corrections.